title: Cardiovascular risk profile and frailty in a population-based study of older British men.
abstract: BACKGROUND
  Frailty in older age is known to be associated with cardiovascular disease (CVD) risk. However, the extent to which frailty is associated with the CVD risk profile has been little studied. Our aim was to examine the associations of a range of cardiovascular risk factors with frailty and to assess whether these are independent of established CVD.
  
  
  METHODS
  Cross-sectional study of a socially representative sample of 1622 surviving men aged 71-92 examined in 2010-2012 across 24 British towns, from a prospective study initiated in 1978-1980. Frailty was defined using the Fried phenotype, including weight loss, grip strength, exhaustion, slowness and low physical activity.
  
  
  RESULTS
  Among 1622 men, 303 (19%) were frail and 876 (54%) were pre-frail. Compared with non-frail, those with frailty had a higher odds of obesity (OR 2.03, 95% CI 1.38 to 2.99), high waist circumference (OR 2.30, 95% CI 1.67 to 3.17), low high-density lipoprotein-cholesterol (HDL-C) (OR 2.28, 95% CI 1.47 to 3.54) and hypertension (OR 1.79, 95% CI 1.27 to 2.54). Prevalence of these factors was also higher in those with frailty (prevalence in frail vs non-frail groups was 46% vs 31% for high waist circumference, 20% vs 11% for low HDL and 78% vs 65% for hypertension). Frail individuals had a worse cardiovascular risk profile with an increased risk of high heart rate, poor lung function (forced expiratory volume in 1 s (FEV1)), raised white cell count (WCC), poor renal function (low estimated glomerular filtration rate), low alanine transaminase and low serum sodium. Some risk factors (HDL-C, hypertension, WCC, FEV1, renal function and albumin) were also associated with being pre-frail. These associations remained when men with prevalent CVD were excluded.
  
  
  CONCLUSIONS
  Frailty was associated with increased risk of a range of cardiovascular factors (including obesity, HDL-C, hypertension, heart rate, lung function, renal function) in older people; these associations were independent of established CVD.
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Ramsay
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Arianayagam
authors.affiliation: Population Health Research Institute, St George's University of London, London, UK.
authors.forename: P H
authors.initials: PH
authors.lastname: Whincup
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: L T
authors.initials: LT
authors.lastname: Lennon
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Cryer
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: A O
authors.initials: AO
authors.lastname: Papacosta
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Department of Primary Care & Population Health, UCL, London, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Wannamethee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology