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Frailty Index Offers Greater Discrimination Than Age for Optimal Blood Pressure Targets: A Pooled Analysis of Two Randomized Trials - PubMed

4 days ago
  • #blood pressure management
  • #hypertension
  • #frailty
  • Frailty index is more effective than age in determining optimal blood pressure (BP) targets for hypertensive patients.
  • A pooled analysis of SPRINT and ACCORD trials included 19,230 participants, with 68.2% classified as frail.
  • Frailty was defined using a 31-item Rockwood cumulative-deficit model with a frailty index >0.21.
  • The study found a J-shaped relationship between average systolic BP (SBP) and major adverse cardiovascular events, with clearer discrimination by frailty than by age.
  • For frail individuals, maintaining SBP between 110-140 mm Hg was associated with lower cardiovascular risk.
  • For non-frail individuals, maintaining SBP below 130 mm Hg was beneficial.
  • Chronological age showed limited discrimination in determining optimal BP targets.
  • The findings were consistent across both SPRINT and ACCORD trials.
  • Frailty index offers a more accurate guide for BP management, though age may remain practical in resource-limited settings.