Frailty and cardiovascular disease: a bidirectional relationship with clinical implications

作者：Neil Johnson, Jing Qu, Kenji Wagatsuma, Yingying Su, Beibei Du, Yuquan He, Ping Yang · 发表于：Frontiers in Cardiovascular Medicine · 年份：2025 · DOI：10.3389/fcvm.2025.1684701 · 被引用次数：16 · 研究领域：Frailty in Older Adults、Chronic Disease Management Strategies、Heart Failure Treatment and Management

Background: Frailty and cardiovascular disease (CVD) are increasingly recognized as interconnected conditions that significantly impact aging populations. This review synthesizes evidence from studies published between 2000 and 2025, identified through Google Scholar and PubMed using keywords such as "frailty", "CVD", "frailty assessment", and "multicomponent interventions". Frailty, characterized by reduced physiological resilience and increased vulnerability to stressors, affects 10%-15% of community-dwelling older adults and is associated with adverse CVD outcomes. Main body: Our analysis demonstrates that frailty and CVD share common pathophysiological mechanisms, including chronic inflammation ("inflammaging"), mitochondrial dysfunction, and endothelial impairment. The reviewed literature reveals frailty prevalence varies substantially by CVD subtype, ranging from 30% in patients with coronary artery disease (CAD) to 80% in those with heart failure (HF). Frailty independently predicts adverse outcomes, conferring a 2.5-3.5-fold higher mortality risk. While multiple assessment tools exist (e.g., Fried Phenotype, Clinical Frailty Scale), this review highlights the absence of a gold standard assessment tool for cardiovascular populations. A critical challenge is that traditional cardiovascular risk scores often fail to account for frailty, leading to significant treatment disparities. Effective management requires a paradigm shift towards multimodal interventions. Evidence ...