The Multiscale Dynamics of Beat-to-Beat Blood Pressure Fluctuation Mediated the Relationship Between Frailty and Arterial Stiffness in Older Adults

Jiang, Xin; Cai, Yurun; Wu, Xiaoyun; Huang, Baofeng; Chen, Yurong; Zhong, Lilian; Gao, Xia; Guo, Yi; Zhou, Junhong

doi:10.1093/gerona/glac035

Cited by 5 publications

(14 citation statements)

References 34 publications

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“…Therefore, the dynamics of the beat-to-beat BP fluctuation is complex, and the complexity in BP fluctuation contains important information of the neurophysiology in vascular system. Studies have shown that the BP complexity, which can be quantified by using multiscale entropy (MSE) ( Costa et al, 2002 , 2005 ), is an appropriate marker to capture the subtle functional changes vascular system and closely associated with frailty ( Jiang et al, 2021 , 2022a , b ). We here followed the protocol that was used in the previous work to record the continuous beat-to-beat BP series of 10–15 min and quantified the complexity of systolic (SBP) and diastolic (DBP) BP using MSE.…”

Section: Methodsmentioning

confidence: 99%

“…For the pre-processing of BP series, we followed the procedure that has been used in our previous studies ( Jiang et al, 2021 , 2022b ). Specifically, the outliers in BP series were determined as those points of the value greater or lower than mean ± two times of standard deviations (SD) of the series.…”

Section: Methodsmentioning

confidence: 99%

“…Specifically, to obtain an appropriate estimate of entropy, the number of data points in the largest-scale coarse-grained series should at least be 10 m to 17 m ; therefore, the appropriate number on the largest scale would be 100∼289 when using m of 2. We thus chose to calculate the MSE over Scale 1 to 5 following our previous work ( Jiang et al, 2021 , 2022a , b ) and the well-established procedure ( Costa et al, 2005 ). The complexity of SBP and DBP was then defined as the averaged entropy across five scales, and lower averaged entropy reflected lower complexity.…”

Section: Methodsmentioning

confidence: 99%

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The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

Jiang

Zhou

et al. 2023

Front. Aging Neurosci.

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BackgroundOlder adults oftentimes suffer from the conditions in multiple physiologic systems, interfering with their daily function and thus contributing to physical frailty. The contributions of such multisystem conditions to physical frailty have not been well characterized.MethodsIn this study, 442 (mean age = 71.4 ± 8.1 years, 235 women) participants completed the assessment of frailty syndromes, including unintentional weight loss, exhaustion, slowness, low activity, and weakness, and were categorized into frail (≥3 conditions), pre-frail (1 or 2 conditions), and robust (no condition) status. Multisystem conditions including cardiovascular diseases, vascular function, hypertension, diabetes, sleep disorders, sarcopenia, cognitive impairment, and chronic pain were assessed. Structural equation modeling examined the interrelationships between these conditions and their associations with frailty syndromes.ResultsFifty (11.3%) participants were frail, 212 (48.0%) were pre-frail, and 180 (40.7%) were robust. We observed that worse vascular function was directly associated with higher risk of slowness [standardized coefficient (SC) = −0.419, p < 0.001], weakness (SC = −0.367, p < 0.001), and exhaustion (SC = −0.347, p < 0.001). Sarcopenia was associated with both slowness (SC = 0.132, p = 0.011) and weakness (SC = 0.217, p = 0.001). Chronic pain, poor sleep quality, and cognitive impairment were associated with exhaustion (SC = 0.263, p < 0.001; SC = 0.143, p = 0.016; SC = 0.178, p = 0.004, respectively). The multinomial logistic regression showed that greater number of these conditions were associated with increased probability of being frail (odds ratio>1.23, p < 0.032).ConclusionThese findings in this pilot study provide novel insights into how multisystem conditions are associated with each other and with frailty in older adults. Future longitudinal studies are warranted to explore how the changes in these health conditions alter frailty status.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

Jiang

Zhou

et al. 2023

Front. Aging Neurosci.

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“…The health of the vascular structure can be examined indirectly by measuring stiffness based on the pulse wave velocity (PWV) or ankle‐brachial index (ABI). Higher brachia‐ankle PWV significantly correlates with physical frailty in older adults 82 . A recent study suggested that the ankle‐brachial PWV might be responsible for the association between aging and sarcopenia risk 83 .…”

Section: Vascular Frailty: How To Operationalize?mentioning

confidence: 99%

“…Higher brachia-ankle PWV significantly correlates with physical frailty in older adults. 82 A recent study suggested that the ankle-brachial PWV might be responsible for the association between aging and sarcopenia risk. 83 Low ABI similarly exhibits an association with poor functional status in the hospitalized older patients.…”

Section: Specific Populations In Which Vascular Frailty May Occurmentioning

confidence: 99%

Vascular frailty, a proposal for new frailty type: A narrative review

Chao

Hung

2023

The Kaohsiung J of Med Scie

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Frailty is the incremental accumulation of minute defects that progressively impair health and performance. Frailty is commonly observed in older adults; however, secondary frailty may also occur in patients with metabolic disorders or major organ failure. In addition to physical frailty, several distinct types of frailty have been identified, including oral, cognitive, and social frailty, each of which is of practical importance. This nomenclature suggests that detailed descriptions of frailty can potentially advance relevant researches. In this narrative review, we first summarize the clinical value and plausible biological origin of frailty, as well as how to appropriately assess it using physical frailty phenotypes and frailty indexes. In the second part, we discuss the issue of vascular tissue as a relatively underappreciated organ whose pathologies contribute to the development of physical frailty. Moreover, when vascular tissue undergoes degeneration, it exhibits vulnerability to subtle injuries and manifests a unique phenotype amenable to clinical assessment prior to or accompanying physical frailty development. Finally, we propose that vascular frailty, based on an extensive set of experimental and clinical evidence, can be considered a new frailty type that requires our attention. We also outline potential methods for the operationalization of vascular frailty. Further studies are required to validate our claim and sharpen the spectrum of this degenerative phenotype.

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The physiologic complexity of beat‐to‐beat blood pressure is associated with age‐related alterations in blood pressure regulation

Jiang,

Mang,

Zhou

et al. 2023

Aging Cell

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The fluctuations in resting‐state beat‐to‐beat blood pressure (BP) are physiologically complex, and the degree of such BP complexity is believed to reflect the multiscale regulation of this critical physiologic process. Hypertension (HTN), one common age‐related condition, is associated with altered BP regulation and diminished system responsiveness to perturbations such as orthostatic change. We thus aimed to characterize the impact of HTN on resting‐state BP complexity, as well as the relationship between BP complexity and both adaptive capacity and underlying vascular characteristics. We recruited 392 participants (age: 60–91 years), including 144 that were normotensive and 248 with HTN (140 controlled‐ and 108 uncontrolled‐HTN). Participants completed a 10‐min continuous finger BP recording during supine rest, then underwent measures of lying‐to‐standing BP change, arterial stiffness (i.e., brachial‐ankle pulse wave velocity), and endothelial function (i.e., flow‐mediated vasodilation). The complexity of supine beat‐to‐beat systolic (SBP) and diastolic (DBP) BP was quantified using multiscale entropy. Thirty participants with HTN (16 controlled‐HTN and 14 uncontrolled‐HTN) exhibited orthostatic hypotension. SBP and DBP complexity was greatest in normotensive participants, lower in those with controlled‐HTN, and lowest in those in uncontrolled‐HTN (p < 0.0005). Lower SBP and DBP complexity correlated with greater lying‐to‐standing decrease in SBP and DBP level (β = −0.33 to −0.19, p < 0.01), greater arterial stiffness (β = −0.35 to −0.18, p < 0.01), and worse endothelial function (β = 0.17–0.22, p < 0.01), both across all participants and within the control‐ and uncontrolled‐HTN groups. These results suggest that in older adults, BP complexity may capture the integrity of multiple interacting physiologic mechanisms that regulate BP and are important to cardiovascular health.

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The Multiscale Dynamics of Beat-to-Beat Blood Pressure Fluctuation Mediated the Relationship Between Frailty and Arterial Stiffness in Older Adults

Cited by 5 publications

References 34 publications

The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

The alterations in multiple neurophysiological procedures are associated with frailty phenotype in older adults

Vascular frailty, a proposal for new frailty type: A narrative review

The physiologic complexity of beat‐to‐beat blood pressure is associated with age‐related alterations in blood pressure regulation

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