To the Editor:
I read with interest the article by Ma and colleagues.1 The authors conducted a prospective study to know the association between frailty and mortality in patients with hypertension aged ≥60 years old. Frailty was significantly associated with poorer physical function, and age‐ and sex‐adjusted hazard ratio (95% confidence interval [CI]) of frailty for mortality was 2.61 (2.11‐3.23). I have some concerns about their study.
First, Castrejón‐Pérez2 explored the association between frailty, diabetes, and hypertension in older adults. By multiple linear regression analysis, diabetes, hypertension, or both conditions were independently associated with frailty, presenting standardized multiple regression coefficients of 0.28, 0.4, and 0.63, respectively. In addition, having diabetic complication was significantly associated with frailty. Taken together, comprehensive analysis by including metabolic disorders should be considered to know the relationship between frailty and hypertension.
Second, Bromfield et al3 conducted a prospective study on blood pressure, antihypertensive medication, frailty, and the risk of serious fall injuries among older patients with hypertension aged ≥65 years old. Adjusted hazard ratios (95% CIs) of frailty for serious fall injuries in patients with 1, 2, or ≥3 indicators of frailty versus no frailty indicators were 1.18 (0.99‐1.40), 1.49 (1.19‐1.87), and 2.04 (1.56‐2.67), respectively. In contrast, values of blood pressure and the number of antihypertensive medication were not significantly associated with increased risk of serious fall injuries. Appropriate intervention on frailty would lead to prevent serious fall injuries, which would also relate to the prognosis of patients with hypertension. Caution should not be paid only to hypertensive medication.
Finally, physical frailty and cognitive impairment are closely associated, and functional/cognitive impairment and frailty are significantly and independently associated with adverse health outcomes, including serious fall injuries. Appropriate screening tool for frailty should be used to avoid falls and to keep quality of life in older patients.4, 5
CONFLICT OF INTEREST
None declared.
REFERENCES
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