Kremer KM, Braisch U, Rothenbacher D, et al. - Among community-dwelling older adults, the relationship between systolic blood pressure (SBP) and 8-year all-cause mortality was shown to be modified by frailty. A likely protective impact for increased SBP was suggested in frail older adults with respect to all-cause death even post-adjusting for diastolic blood pressure and antihypertensive therapy.

• Using longitudinal data from the ActiFE Ulm study (Activity and Function in the Elderly in Ulm; Germany), this study included 1,170 participants (median age 73.9 years) in whom prevalence of history of hypertension was 53.8%.

• A total of 251 participants (21.5%, 114 deaths) were frail (frailty index ≥0.2), and effect modification by frailty was evident.

• A J-shaped link was evident in non-frails, with hazard ratio, 4.01 for SBP<110 mm Hg, 0.92 for SBP 140–150 mm Hg, and 1.98 for SBP≥160 mm Hg.

• There was a tendency toward lower risk in frail older adults with SBP≥130 mm Hg.