Abstract: FR-PO377
Influences of Blood Pressure-Lowering Agents on Frailty Progression in Patients with Type 2 Diabetes: A Longitudinal Cohort Study
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Chao, Chia-Ter, National Taiwan University Hospital, Taipei, Taiwan
- Wang, Jui, National Taiwan University College of Public Health, Taipei, Taiwan
Group or Team Name
- Cohort of Geriatric Nephrology in NTUH (COGENT Study Group).
Background
Patients with diabetes mellitus (DM) face an elevated risk of developing frailty characterized by increased vulnerability to adverse stimuli. Although the likelihood of frailty development in this population has been explored, few studies investigate the risk factors associated with frailty progression. We examined the influence of different types of blood pressure (BP)-lowering agents on the risk of exacerbating frailty in patients with DM.
Methods
We identified adult patients with type 2 DM from the integrated medical database of National Taiwan University Hospital and its affiliated branches. Clinical variables were recorded and monitored to assess the primary outcome: worsening of frailty. Cox proportional hazards analysis was employed to determine the risk of frailty progression associated with specific classes of BP-lowering agents, adjusting for multiple confounders.
Results
A total of 41,440 patients (mean 64.1 years; 46.3% females) were included, with 27.4% experiencing worsening frailty during 4.09 years of follow-up. The use of at least 1 anti-hypertensive class significant increased the risk of frailty progression (Figure). Cox regression analysis, accounting for potential confounders, revealed that users of diuretics had a significantly higher risk of frailty progression (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.06-1.18), as did α-blocker users (HR 1.14, 95% CI 1.06-1.23). Conversely, β-blocker users exhibited a significantly reduced risk (HR 0.93, 95% CI 0.88-0.98). Moreover, longer durations and higher dosages of β-blocker use decreased the risk of frailty progression, while diuretics use demonstrated the opposite trend.
Conclusion
Our findings suggest that the choice of BP-lowering agents may significantly impact the risk of frailty progression in patients with DM. Clinicians should carefully consider the potential benefits and risks associated with specific classes of BP-lowering agents when managing hypertensive patients with DM, particularly in relation to frailty-related outcomes.