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

  • Zheng-Dong Wang
  • Shun Yao
  • Guo-Ping Shi
  • Yong Wang
  • Jian-Ming Shi
  • Jiang-Hong Guo
  • Yin-Sheng Zhu
  • Xiao-Yan Jiang
  • Xue-Feng ChuEmail author
  • Xiao-Feng WangEmail author
Original Article


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.


Data of 1382 community-dwelling elders who had no documented cardiovascular diseases aged 70–84 years 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 ≥ 100pg/mL. Cardiovascular events include incident major cardiovascular events and cardiovascular death.


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 = 1.16, 95% CI 1.01–1.34). Frailty index was not only associated with cardiovascular events (HR = 1.32, 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 = 1.93, 95% CI 1.67–3.17) and pre-frailty (OR = 1.54, 95% CI 1.06–2.25) were associated with increased risk of elevated BNP.


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.


Cardiovascular diseases BNP Traditional risk factors Frailty index 



We acknowledge all participants involved in the present study.


This work was financially supported by grants from the National Key R&D Program of China (2018YFC2000400, 2018YFC2002000), the National Natural Science Foundation of China (81571372, 81670465, 81600577), the Shanghai natural science grant (16ZR1449400).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Human Ethics Committee of the School of Life Sciences, Fudan University, Shanghai, People’s Republic of China, approved the present study.

Informed consent

Written informed consent was obtained from all participants prior to the study.

Supplementary material

40520_2019_1189_MOESM1_ESM.docx (18 kb)
Supplementary file1 (docx 17 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Zheng-Dong Wang
    • 1
  • Shun Yao
    • 2
    • 3
  • Guo-Ping Shi
    • 1
  • Yong Wang
    • 1
  • Jian-Ming Shi
    • 1
  • Jiang-Hong Guo
    • 1
  • Yin-Sheng Zhu
    • 1
  • Xiao-Yan Jiang
    • 4
  • Xue-Feng Chu
    • 1
    Email author
  • Xiao-Feng Wang
    • 2
    • 3
    Email author
  1. 1.Rugao People’s HospitalRugaoChina
  2. 2.State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Science and Institutes of Biomedical SciencesFudan UniversityShanghaiChina
  3. 3.National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
  4. 4.Key Laboratory of Arrhythmias of the Ministry of Education of ChinaTongji University School of MedicineShanghaiChina

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