Frailty index is associated with increased risk of elevated BNP in an elderly population: the Rugao Longevity and Ageing Study

Abstract

Background and aims To explore whether frailty, defined by frailty index (FI), is associated with the risk of elevated B-type natriuretic peptide (BNP), a surrogate endpoint of cardiovascular events. Methods Data of 1382 community-dwelling elders who had no documented cardiovascular diseases aged 70–84\xa0years from the ageing arm of the Rugao Longevity and Ageing Study was used. Traditional risk factor index (TI) was constructed using eight established cardiovascular-related risk factors. FI was constructed using 36 health deficits. Elevated BNP was defined as BNP ≥\u2009100pg/mL. Cardiovascular events include incident major cardiovascular events and cardiovascular death. Results During a 3-year follow-up period, 97 participants had cardiovascular events. TI was not associated with the risk of elevated BNP, but was associated with cardiovascular events (HR\u2009=\u20091.16, 95% CI 1.01–1.34). Frailty index was not only associated with cardiovascular events (HR\u2009=\u20091.32, 95% CI 1.06–1.64), but also associated with elevated BNP with an OR of 1.22 (95% CI 1.02–1.47) for each 0.1 increment. Further, both frailty (OR\u2009=\u20091.93, 95% CI 1.67–3.17) and pre-frailty (OR\u2009=\u20091.54, 95% CI 1.06–2.25) were associated with increased risk of elevated BNP. Conclusion FI is associated with increased risks of both cardiovascular events and surrogated endpoint of cardiovascular disease—elevated BNP. Frailty may be a non-traditional risk factor of cardiovascular diseases and frailty index may be a measurement for early identifying high risk elderly individuals of cardiovascular abnormities.