Longevity & AgingFrailty and Heart Disease Fuel Each Other, and Routine Frailty Screening Could Break the Cycle
This narrative review explains why frailty and cardiovascular disease (CVD) so often occur together. Both are driven by shared aging processes: chronic low-grade inflammation, mitochondrial dysfunction, endothelial decline and neurohormonal dysregulation. Frailty affects 10-15% of community-dwelling older adults, but prevalence ranges from about 30% in coronary artery disease to 80% in heart failure. Frailty is linked to a 2.5-3.5-fold higher mortality risk, yet standard cardiovascular risk scores largely ignore it. The authors call for routine frailty assessment in cardiology and for multimodal care, combining exercise and nutrition (for example VIVIFRAIL and SPRINT-T). They also highlight emerging approaches such as senolytics, stem cell mobilization and angiogenic gene therapy that target shared biology.