Frailty syndrome and associated factors among patients with hypertension: A cross-sectional study in Kumasi, Ghana

Background and Aim: Frailty is a condition marked by accumulation of biological deficits and dysfunctions that come with aging and it is correlated with high morbidity and mortality in patients with cardiovascular diseases, particularly hypertension. Hypertension continues to be a leading cause of cardiovascular diseases and premature death globally. However, there is dearth of literature in sub-Saharan Africa on frailty syndrome among hypertensives on medication. This study evaluated frailty syndrome and its associated factors among Ghanaian hypertensives. Methods: This cross-sectional study recruited 303 patients with hypertension from the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Data on sociodemographic, lifestyle and clinical factors were collected using a well-structured questionnaire. Medication adherence was measured using Adherence in Chronic Disease Scale, and frailty was assessed by Tilburg Frailty Indicator. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism 8.0. p-value of < 0.05 and 95% confidence interval (CI) were considered statistically significant. Results: The prevalence of frailty was 59.7%. The proportion of high, medium and low medication adherence was 23.4%, 64.4% and 12.2%, respectively. Being >= 70years (adjusted odds ratio [aOR]: 8.33, 95% CI [3.72-18.67], p < 0.0001), unmarried (aOR: 2.59, 95% CI [1.37-4.89], p = 0.0030), having confirmed hypertension complications (aOR: 3.21, 95% CI [1.36-7.53], p = 0.0080), medium (aOR: 1.99, 95% CI [1.05-3.82], p = 0.0360) and low antihypertensive drug adherence (aOR: 27.69, 95% CI [7.05-108.69], p < 0.0001) were independent predictors of increased odds of developing frailty syndrome. Conclusion: Approximately 6 out of 10 Ghanaian adult patients with hypertension experience frailty syndrome. Hypertension complications, older age, being unmarried, and low antihypertensive drug adherence increased the chances of developing frailty syndrome. These should be considered in intervention programmes to prevent frailty among patients with hypertension.