Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.
Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.
Exp Gerontol. 2021 Oct 1;153:111480. doi: 10.1016/j.exger.2021.111480. Epub 2021 Jul 12.
Frailty and cardiovascular disease share some of the pathophysiologic features. Our objective was to review and metaanalyse the available published evidence on the topic. We performed a comprehensive literature search for studies where pulse wave velocity (PWV) or carotid-ankle vascular index (CAVI) has been linked with frailty in older persons. Of the initial 362 abstracts, after the application of the PRISMA approach, 5 were analysed in detail. We calculated within-study and pooled standardised mean differences of aortic stiffness measures between frail and non-frail (0.62 [0.31-0.92], p < 0.0001, I = 88%), and pre-frail and non-frail (0.32 [0.14-0.51], p = 0.0006, I = 72%) groups. In two studies it was possible to extract directly or calculate based on published data the odds ratios for the concomitant frailty, associated in one case with CAVI greater by 1 m/s and in another with cfPWV >13 m/s, indicating greater probability of concomitant frailty given greater aortic stiffness. Across the studies, the prevalence of hypertension, diabetes mellitus, hyperlipidaemia, and smoking tended to increase from non-frail, to pre-frail, and frail groups, presenting a possibility of important confounding, but also a common pathophysiology. In conclusion, the pooled analysis of the published cross-sectional study results indicates a relation between aortic stiffness and frailty in older subjects. However, well designed prospective studies are needed to answer the questions of causality.
虚弱和心血管疾病有一些共同的病理生理特征。我们的目的是回顾和荟萃分析关于这一主题的现有文献证据。我们对将脉搏波速度(PWV)或颈-踝血管指数(CAVI)与老年人虚弱相关联的研究进行了全面的文献检索。在最初的 362 篇摘要中,在应用 PRISMA 方法后,有 5 篇被详细分析。我们计算了主动脉僵硬测量值在虚弱和非虚弱(0.62 [0.31-0.92],p<0.0001,I=88%),以及虚弱前和非虚弱(0.32 [0.14-0.51],p=0.0006,I=72%)组之间的研究内和汇总标准化均数差。在两项研究中,可以直接提取或根据已发表的数据计算同时发生的虚弱的比值比,在一种情况下,与 CAVI 增加 1 m/s 相关,在另一种情况下,与 cfPWV>13 m/s 相关,表明在给定更大的主动脉僵硬的情况下,同时发生虚弱的可能性更大。在这些研究中,高血压、糖尿病、高脂血症和吸烟的患病率倾向于从非虚弱、虚弱前到虚弱组增加,这表明存在重要的混杂因素,但也存在共同的病理生理学。总之,对已发表的横断面研究结果的汇总分析表明,在老年患者中,主动脉僵硬与虚弱之间存在关系。然而,需要进行精心设计的前瞻性研究来回答因果关系的问题。