Office and home blood pressure and their difference according to frailty status among community-dwelling older adults: the NOSE study

Abstract

The relationship between frailty and blood pressure (BP) is inconsistent, and limited research has compared BP by frailty status using long-term home BP measurements. We aimed to identify office and home BP and determine differences according to frailty status, stratified by taking antihypertensives in community-dwelling older adults. This cross-sectional study was part of the ongoing non-randomized intervention NOSE study. Participants were aged ≥ 64 years. Frailty was categorized robust, pre-frailty, or frailty using the revised Japanese version of the Cardiovascular Health Study criteria. Office BP was measured in survey settings, and each participant was instructed to take home BP. We used the average home BP for 4 weeks post-survey. An analysis of covariance analyzed the relationship between frailty and office and home BP, and their differences stratified by antihypertensive use. We included 418 older participants (mean age: 72.8 years); 39.5% were male, 40.4% were taking antihypertensives, and 6.7% had frailty. Individuals with frailty taking antihypertensives had higher home morning systolic BP (SBP) than those with robust (134.2 vs. 145.7 mmHg, P = 0.018) and pre-frailty (135.6 vs. 145.7 mmHg, P = 0.024). The difference between office and morning home SBP in treated participants was 7.1 mmHg (robust), 4.7 mmHg (pre-frailty), and −5.1 mmHg (frailty), showing significant differences (robust vs. frailty: P = 0.005, pre-frailty vs. frailty: P = 0.016). Home morning SBP was higher in individuals with frailty taking antihypertensives compared to those without frailty, and it may be higher than office BP. Individuals with frailty should measure home BP for good BP control.