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Subclinical Cardiovascular Damage Boosts Fall Risk in Older Adults


October 09, 2019

Older adults with certain markers of subclinical cardiovascular disease have more than double the risk of falls, according to a study in the Journal of the American Geriatrics Society. 

“Cardiovascular disease is associated with greater fall risk; however, it is unknown if pathways that contribute to cardiovascular disease, such as subclinical myocardial damage or wall strain, are related to future falls,” researchers wrote. “We hypothesized that elevations in high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), measured in older adults, would be associated with greater fall risk.” 

For the prospective study, researchers looked at data for 3973 older adults without known coronary heart disease, heart failure, or stroke who had hs-cTnT or NT-proBNP measured and were then followed for a median 4.5 years. Over the follow-up period, 457 participants experienced a fall. 

Older adults in the highest quartiles of hs-cTnT or NT-proBNP measurements had a greater than twofold risk of falling compared with older adults whose measurements were in the lowest quartiles, the study found. Specifically, the fall risk hazard ratio for older adults in the highest hs-cTnT quartile was 2.17. Older adults in the highest NT-proBNP quartile had a falls risk hazard ratio of 2.34. 

The relationships between falls and hs-cTnT and NT-proBNP were significant and independent, according to the study. 

“Subclinical elevations of cardiac damage and wall strain were each associated with a higher fall risk in older adults,” researchers wrote. “Further research is needed to determine whether interventions that lower hs-cTnT or NT-proBNP also lower fall risk.”

Jolynn Tumolo

Reference

Juraschek SP, Daya N, Appel LJ, et al. Subclinical cardiovascular disease and fall risk in older adults: results from the Atherosclerosis Risk in Communities study [published online ahead of print July 10, 2019]. J Am Geriatr Soc. 2019;67(9):1795-1802. doi: 10.1111/jgs.16041

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