Fenótipo de pré-fragilidade, rigidez arterial e pressão arterial em idosos: um estudo transversal

Abstract

Background: pre-frailty phenotype is associated with increased risk for cardiovascular disease (CVD) among older adults. The factors that could explain the association between pre-frailty and CVD are not clear. However, Arterial stiffness and blood pressure (BP) are strong predictors of CVD. Methods: This cross-sectional study included 249 community-dwelling older adults aged 60- 80 years. Pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Muscle weakness was defined by the lowest quintile of handgrip strength stratified by sex and body mass index, walking slowness was defined by the lowest quintile of walking time/4.6m stratified by sex and height, and low physical activity was defined lowest quintile of metabolic equivalents/week stratified by sex. Exhaustion and unintentional weight loss followed Fried's original criteria. Participants with 1 or 2 standardized Fried criteria were classified as pre-frail and those with 0 criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). A generalized linear model was used for data analysis. Results: From 249 participants (79.5% females), 61.8% (n = 154) were pre-frail (65.9 ± 5.4 years old), 38.2% (n = 95) robust (66.5 ± 5.3 years old) and 8.7% (n = 24) frail (65.2 ± 5.2 years old). Pre-frail older adults had higher VOPa (β = 0.19 m/s; p = 0.007) compared to their robust peers. In addition, the pre-frail older adults had higher central systolic BP (β = 4.8 mmHg, p = 0.021) and central pulse pressure (PP) (β = 2.9 mmHg, p = 0.014), brachial systolic BP ( β = 5.3 mmHg, p = 0.017), mean brachial BP (β = 3.1 mmHg, p = 0.046) and brachial PP (β = 3.3 mmHg, p = 0.017) compared with robust older adults.Conclusions: the pre-frailty phenotype was associated with greater arterial stiffness in community-dwelling older adults without CVD diagnosis. Increased arterial stiffness could partially explain the association between pre-frailty and CVD in the older adults. Arterial stiffness and increased BP could partially explain the association between pre-frailty and CVD in the older adults.