Frequency of adverse outcomes in hypertensive patients aged 80 years and older depending on heart failure and frailty syndrome

Aim. To assess the frequency of adverse outcomes during 12-month follow-up in hypertensive (HTN) patients depending on heart failure (HF) and frailty syndrome (FS). Material and methods. The study included 320 patients with HTN, who were divided by HF and FS into following groups: group 1A — patients with HTN, FS and HF (n=84), group 1B — patients with HTN, FS without HF (n=77), group 2A — patients with HTN, HF without FS (n=84), group 2B — patients with HTN and without HF and FS (n=75). The FS was identified using the "Age is not a hindrance" questionnaire, and the incidence of adverse outcomes (composite endpoint and all-cause mortality) was analyzed after 12 months. The composite endpoint was cardiovascular mortality and HF-related hospitalization rate. Results. In HF, the risk of composite endpoint was 2,9 times higher in FS patients with hypertension (p=0,028), while there was no significant effect on all-cause mortality (p=0,526). In non-FS patients with HTN, HF was accompanied by a 6,6-fold increase in the risk of composite endpoint (p=0,015) and a tendency to an increase in all-cause mortality (p=0,079). FS contributed to an increase in the risk of composite endpoint and all-cause mortality in non-HF patients with HTN by 4 and 3 times, respectively (when comparing groups 1B and 2B), and in patients with HTN and HF — by 76,4% and 49,4%, respectively (when comparing groups 1A and 2A). With a combination of FS and HF, patients with HTN had the highest incidence of composite endpoint (11,7 times) and all-cause mortality (3,1 times) compared with patients with HTN without HF and FS. Conclusion. HF contributes to a significant increase in the risk of cardiovascular mortality and hospitalization due to HF in hypertensive patients with and without FS. A tendency towards an increase in all-cause mortality was demonstrated in FS patients with HTN and HF. FS increases the incidence of composite endpoint and all-cause mortality in patients with HTN regardless of HF. The combination of FS and HF in patients with HTN increases the risk of composite endpoint and all-cause death to the greatest extent.