ArticleEClinicalMedicine2022
Do the frail experience more adverse events from intensive blood pressure control? A 2-year prospective study in the Irish Longitudinal Study on Ageing (TILDA).
Article in EClinicalMedicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Cardiovascular frailty - an emerging frailty phenotype.Journal of human hypertension · 2026Review
- The Effect Modification of Systolic Blood Pressure on the Association of Frailty and Cardiovascular Disease in Community-Dwelling Adults.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Risk of falls and syncope across frailty levels in hypertensive older adults: a longitudinal study.GeroScience · 2026Article
- Review of Blood Pressure Control in Vulnerable Older Adults: The Role of Frailty and Sarcopenia.Journal of vascular diseases · 2025Article
- Hypertension and orthostatic hypotension in the elderly: a challenging balance.The Lancet regional health. Europe · 2025Review
- Intensive antihypertensive treatment does not lower cerebral blood flow or cause orthostatic hypotension in frail older adults.GeroScience · 2024Observational
- Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA).Sensors (Basel, Switzerland) · 2024Observational
- Integrating frailty interventions into existing care models: a comprehensive approach to enhancing patient outcomes in chronic disease management.Frontiers in public health · 2024Review
- Current issues in frailty and hypertension management.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Review
- Eight-year longitudinal falls trajectories and associations with modifiable risk factors: evidence from The Irish Longitudinal Study on Ageing (TILDA).Age and ageing · 2023Observational
- Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.Frontiers in cardiovascular medicine · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for management of hypertension in adults aged ≥65 years recommend a blood pressure (BP) treatment target of 130-139/70-79 mmHg if tolerated. Randomised controlled trials have advocated for lower BP, but this may have adverse outcomes in the frail. Yet, definitions of frailty vary.
methodsUsing a prospective, observational study design, we compared two frailty classifications in their ability to predict short-term adverse outcomes associated with intensive BP control (<130/70 mmHg) in The Irish Longitudinal Study on Ageing (TILDA). Data from participants aged ≥65 treated for hypertension in Wave 1 (W1) between October 2009 and June 2011 were analysed. Frailty was identified by Frailty Phenotype (FP) and the Clinical Frailty Scale (CFS). We formulated 8 participant groups based on frailty-BP combinations. Outcomes at wave 2 (W2) in 2012-2013 were analysed with adjusted binary logistic regression models.
findingsOf 1920 W1 participants aged ≥65 and treated for hypertension, 1229 had full BP/FP and 1282 BP/CFS data. While the FP only identified risk of hospitalisation associated with intensive BP treatment, intensively treated frail-by-CFS participants had no increased or decreased risk of adverse outcomes, but those treated above the target had a higher risk of falls/fractures. In the non-frail by FP, intensive blood pressure treatment was associated with reduced risk of falls/fractures.
interpretationDifferent frailty classifications may have different prognostic implications for the purpose of the application of hypertension management guidelines. Our study had limited power due to low frailty prevalences, so further research is needed. Guidelines should specify the recommended frailty identification method/s. In the frail, therapy personalisation is needed.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.