The frail patient with heart disease: An emerging and challenging issue

Frailty and cardiovascular disease (CVD) are two common conditions that may affect clinical outcomes in older people. Epidemiological studies suggest that CVD is one of the most important contributor to the development of frailty in the aged patient, and the latter can therefore be considered a potential CVD risk factor. Moreover, traditional CVD risk factors are also known to be important for developing frailty. This close relationship between CVD and frailty is due, in part, to the shared etiological factors, which include low-grade inflammation, cellular senescence, and endocrine dysregulation. Therefore, the early detection of frailty is important in the management of patients with CVD or in those who are at a high risk of developing CVD. In this regard, the use of a comprehensive geriatric assessment (CGA) may be considered in these patients. Unfortunately, the literature available for the use of CGA is only based on observational data, which may be biased; therefore, future studies are needed to understand the true role of CGA for detecting frailty in patients with CVD. In this article, an overview is provided of the current evidence regarding frailty, CVD, and their coexistence in terms of the underlying pathophysiology and their impact on clinical outcomes. © 2018 Les Laboratoires Seriver. All Rights Reserved.