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Frailty linked to suboptimal blood pressure control in older women with hypertension, study finds

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A cross-sectional study of 1,038 hypertensive adults aged 60+ in Vietnam found frailty was more common among women (35%) than men (26%).

Key Findings

  • Suboptimal blood pressure (BP) rates were similar between sexes (women 25.5%, men 27.2%).
  • Frail women had approximately twice the odds of suboptimal BP (OR 2.01) compared to non-frail women; no association was observed in men (OR 0.92).
  • The sex difference in the frailty-BP association was significant (female-to-male OR ratio 2.18).

Study Details

  • Data were collected from outpatient clinics at two major hospitals in Vietnam (2023–2024).
  • Frailty was assessed using the Clinical Frailty Scale (score ≥4).
  • Suboptimal BP defined as systolic ≥140 mmHg or diastolic ≥90 mmHg per Vietnamese guidelines.
  • Models adjusted for age, education, exercise, marital status, falls, comorbidities, hypertension duration, medication type, and adherence.

Potential Explanations

  • Clinicians may be less aggressive in lowering BP in women due to higher risk of falls and osteoporosis.
  • Sex differences in medication metabolism could affect treatment outcomes.
  • The study could not separate biological sex from gender-related factors (e.g., education, caregiving roles).

Limitations

  • Cross-sectional design prevents causal inference.
  • Retrospective BP records, not standardized measurements.
  • Participants from specialist clinics had high multimorbidity/polypharmacy; results may not generalize to all community-dwelling older adults.

Implications

  • Routine frailty screening may help identify high-risk older women for personalized BP management.
  • Future prospective studies should examine how frailty-informed BP control affects cardiovascular outcomes.