Correlation Between Blood-pressure Levels and Frailty Index and Adverse Health Events in Older Adults With ESRD With Hypertension.

ABSTRACT

Context End-stage renal disease (ESRD) refers to the development of chronic kidney disease to stage 5. Elevated blood pressure is one of the main symptoms of older adults with ESRD. The severity and difficulty of curing ESRD with hypertension in older adults has attracted a great deal of attention from the medical community. Objective: The study intended to analyze the correlation between blood-pressure level and FRAIL scores and adverse health events for older adults with ESRD and hypertension. Design: The research team performed a narrative review by searching hospital medical record system databases. The search used the keywords endpoint renal disease and hypertension. The research team also conducted a prospective case-control study. Setting: The study took place at Peking University International Hospital. Participants: Participants were 168 older adults with ESRD and hypertension, ESRD only, or hypertension only who had received a diagnosis and treatment at the hospital between October 2022 and September 2023 as well as healthy individuals who were members of the community. Groups The study included four groups, each with 42 participants: (1) the ESRD + hypertension group, (2) the ESRD group, (3) the hypertension group, and (4) the healthy group. Outcome Measures: The research team (1) measured systolic and diastolic blood pressure, (2) assessed patients' debilitation using the FRAIL score; and (3) determined the incidence of adverse health events-heart disease, stroke, cancer, arthritis, and chronic obstructive pulmonary disease (COPD). Based on participants' blood pressures, the research team (1) divided the ESRD with hypertension group into the hypertension grade I, hypertension grade II, and hypertension grade III groups, and (2) compared the blood pressures, FRAIL scores, and incidence of adverse health events among those three groups. The team performed a Pearson correlation analysis to analyze the correlation between blood pressure and the FRAIL scores and adverse health events for the ESRD with hypertension group. Results: The ESRD + hypertension group's mean systolic and diastolic blood pressure and FRAIL score and its incidence of adverse health events were significantly higher than those (1) of the ESRD group, with P = .028, P = .048, P = .037, and P = .008, respectively; (2) of the hypertension group, with P = .017, P = .035, P = .025, and P = .037, respectively; and (3) of the healthy group, with P = .042, P = .341, P = .372, and P = .482, respectively. The hypertension grade III's systolic and diastolic blood pressure, FRAIL score, and incidence of adverse health events were significantly higher than those (1) of the hypertension grade I group, with P = .009, P = .015, P = .003, and P = .055, respectively, and (2) of the grade II group, with P = .078, P = .089, P = .001, and P = .006, respectively. A significant positive correlation existed between the blood-pressure level and the FRAIL score (P = .041) and incidence of adverse health events (P = .032). Conclusions: Older adults with ESRD and hypertension had significantly higher blood pressure levels and FRAIL scores and more adverse health events. A significant positive correlation existed between blood pressure level and frailty scores and incidence of adverse health events.