Frailty may help identify older women with hypertension who are more likely to have suboptimal blood pressure control, according to a Vietnamese outpatient study published on Jun. 8. The research raises questions about how sex, aging, falls risk, and treatment decisions intersect in cardiovascular care.
The study appeared as an "Article in Press" in the journal Scientific Reports and found that frailty was more common among older women than men. While overall rates of suboptimal blood pressure were similar between sexes, frail women had approximately twice the odds of suboptimal control compared to non-frail women. No such association was observed for men. The authors said these findings suggest the need for more personalized strategies for blood pressure management focused on older women with frailty.
Researchers analyzed data from hypertensive adults aged 60 years or older attending outpatient clinics at two major hospitals in Vietnam between 2023 and 2024. All participants had a physician-confirmed hypertension diagnosis or were using antihypertensive medications. Data included sociodemographic information, medical history, and details on medication use collected through health records and interviews.
Frailty was assessed using the Clinical Frailty Scale, with a score of four or higher indicating frailty. Suboptimal blood pressure thresholds followed recommendations from the 2022 Vietnamese Society of Hypertension Guidelines: systolic at least 140 mmHg or diastolic at least 90 mmHg based on clinic readings documented over six months.
Of the 1,038 participants (mean age: 73 years; 326 women), nearly half had coronary heart disease or type 2 diabetes. About two-thirds used combination therapies for hypertension; however, men were significantly more likely than women to be prescribed such regimens. Frailty prevalence was higher among females (35%) compared to males (26%), while about one-quarter overall had suboptimal blood pressure levels.
The researchers concluded that routine screening for frailty among older hypertensive adults could enable earlier intervention and better outcomes, but cautioned that their cross-sectional design does not prove causality between frailty and poor blood pressure control.
