The Multiscale Dynamics of Beat-to-Beat Blood Pressure Fluctuation Mediated the Relationship Between Frailty and Arterial Stiffness in Older Adults

Xin Jiang; Yurun Cai; Xiaoyan Wu; Baofeng Huang; Yurong Chen; Lilian Zhong; Xia Gao; Yi Guo; Junhong Zhou

doi:10.1093/gerona/glac035

The Multiscale Dynamics of Beat-to-Beat Blood Pressure Fluctuation Mediated the Relationship Between Frailty and Arterial Stiffness in Older Adults

J Gerontol A Biol Sci Med Sci. 2022 Dec 29;77(12):2482-2488. doi: 10.1093/gerona/glac035.

Authors

Xin Jiang^{1

2

3}, Yurun Cai^{4

5}, Xiaoyan Wu^{1

2}, Baofeng Huang^{1

2

3}, Yurong Chen¹, Lilian Zhong^{1

2

3}, Xia Gao^{1

2

3}, Yi Guo^{2

3

6

7}, Junhong Zhou^{8

9

10}

Affiliations

¹ Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, People's Republic of China.
² The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, People's Republic of China.
³ The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
⁴ Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁶ Department of Neurology, Shenzhen People's Hospital, Shenzhen, Guangdong, People's Republic of China.
⁷ Shenzhen Bay Laboratory, Shenzhen, Guangdong, People's Republic of China.
⁸ Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, Maryland, USA.
⁹ Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
¹⁰ Harvard Medical School, Boston, Massachusetts, USA.

Abstract

Background: Beat-to-beat blood pressure (BP) is an important cardiovascular output and regulated by neurophysiological elements over multiple temporal scales. The multiscale dynamics of beat-to-beat BP fluctuation can be characterized by "BP complexity" and has been linked to age-related adverse health outcomes. We here aimed to examine whether BP complexity mediates the association between arterial stiffness and frailty.

Method: This cross-sectional study was completed between January and October 2021. A total of 350 older adults completed assessments for frailty, arterial stiffness (ie, average brachial-ankle pulse wave velocity), and beat-to-beat finger BP. The complexity of beat-to-beat systolic blood pressure (SBP) and diastolic blood pressure (DBP) BP series was measured using multiscale entropy. The relationships between frailty, BP complexity, and arterial stiffness were examined using analysis of variance and linear regression models. The effects of BP complexity on the association between arterial stiffness and frailty were examined using mediation analyses.

Results: Compared with non-frail, prefrail, and frail groups had significantly elevated lower SBP and DBP complexity (F > 11, p < .001) and greater arterial stiffness (F = 16, p < .001). Greater arterial stiffness was associated with lower BP complexity (β < -0.42, p < .001). Beat-to-beat SBP and DBP complexity mediated the association between arterial stiffness and frailty (indirect effects >0.28), accounting for at least 47% of its total effects on frailty (mediated proportion: SBP: 50%, DBP: 47%).

Conclusion: This study demonstrates the association between BP complexity and frailty in older adults, and BP complexity mediates the association between arterial stiffness and frailty, suggesting that this metric would serve as a marker to help characterize important functions in the older adults.

Keywords: Arterial stiffness; Beat-to-beat blood pressure; Frailty; Multiscale entropy.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Aged
Ankle Brachial Index
Blood Pressure / physiology
Cross-Sectional Studies
Frailty*
Humans
Hypertension*
Pulse Wave Analysis
Vascular Stiffness* / physiology

Abstract

Publication types

MeSH terms

Grants and funding