Objective

Frailty and pre-frailty are known to increase the risk of developing cardiovascular disease (CVD). However, the risk profiles of females are not well characterized. The aim of this study is to characterize the CVD risk profiles of robust, pre-frail and frail females.

Methods

Cross-sectional analysis of 985 females ≥55 years with no self-reported history of CVD were recruited. Frailty was assessed using the Fried Criteria with the cut-points standardized to the cohort. Framingham risk scores (FRS), the 4-test Rasmussen Disease Score (RDS), and the CANHEART health index were used to characterize composite CVD risk. Individual measures of CVD risk included blood lipids, artery elasticity assessments, exercise blood pressure response, 6-min walk test (6MWT), sedentary time and PHQ-9 score.

Results

The cohort comprised of 458 (46.4%) robust, 464 (47.1%) pre-frail and 63 (6.4%) frail females with a mean age of 66 ± 6 (SD) years. Pre-frail females were at increased odds of taking diabetes medications (OR 3.04; 95% CI 1.27–7.27), hypertension medications (OR 2.02; 95% CI 1.44–2.82), having an exaggerated blood pressure response to exercise (OR 1.878; 95% CI 1.39–2.50), mild depression symptoms (OR 2.38; 95% CI 1.68–338), and lower fitness as assessed by 6MWT (OR 5.74; 95% CI 3.18–10.37), even after controlling for age and relevant medications. Pre-frail females were also at increased odds for having CVD risk scores indicating higher risk with the FRS (OR 1.52; 95% CI 1.12–2.05), the RDS (OR 1.60; 95% CI 1.21–2.10) and the CANHEART risk score (OR 3.07; 95% CI 2.04–4.62). These odds were higher when frail females were compared to their robust peers.

Conclusion

Frailty and pre-frailty were associated with higher odds of presenting with CVD risk factors as compared to robust females, even after controlling for age.

中文翻译：

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中老年女性的虚弱状况和心血管疾病风险状况。

目的

脆弱和虚弱会增加罹患心血管疾病（CVD）的风险。但是，女性的风险状况没有得到很好的表征。这项研究的目的是描述健壮，脆弱和脆弱女性的CVD风险特征。

方法

招募了985名55岁以上，无自我报告的CVD史的女性。使用Fried Criteria对脆弱性进行了评估，并针对该人群标准化了切点。用Framingham风险评分（FRS），4次测试拉斯穆森病评分（RDS）和CANHEART健康指数来表征复合性CVD风险。CVD风险的单独测量包括血脂，动脉弹性评估，运动血压反应，6分钟步行测试（6MWT），久坐时间和PHQ-9得分。

结果

该队列由458名（46.4％）健壮的女性，464名（47.1％）的体弱者和63名（6.4％）的体弱女性组成，平均年龄为66±6（SD）岁。体弱多病的女性服用糖尿病药物（OR 3.04； 95％CI 1.27-7.27），高血压药物（OR 2.02； 95％CI 1.44-2.82）的机率增加，对运动的血压反应较高（OR 1.878； 95％CI 1.39–2.50），轻度抑郁症状（OR 2.38； 95％CI 1.68–338）和通过6MWT评估的较低适应性（OR 5.74； 95％CI 3.18–10.37），即使在控制年龄和相关药物后。体弱前女性的CVD风险评分也更高，表明FRS（OR 1.52; 95％CI 1.12–2.05），RDS（OR 1.60; 95％CI 1.21–2.10）和CANHEART风险评分的风险更高（或3.07； 95％CI 2.04–4.62）。

结论

与健壮的女性相比，即使在控制了年龄之后，虚弱和虚弱也与出现CVD危险因素的可能性较高有关。