Subclinical Cardiovascular Dz May Up Fall Risk in Older Adults

Subclinical cardiovascular disease (CVD) appears to be an independent risk factor for falls in older adults, according to a study published online in the Journal of the American Geriatrics Society.

Stephen P. Juraschek, M.D., Ph.D., from Harvard Medical School in Boston, and colleagues evaluated high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements from participants in the Atherosclerosis Risk in Communities Study without known coronary heart disease, heart failure, or stroke. U.S. Centers for Medicare and Medicaid Services claims were used to identify hospital discharges from falls.

The researchers found that for the 3,973 participants (mean age, 76 years; 62 percent women; 22 percent black), there were 457 falls during a median follow-up of 4.5 years. Across hs-cTnT and NT-proBNP quartiles, fall incidence rates were 17.1, 20.0, 26.2, and 36.4 per 1,000 person-years, respectively, and 12.8, 22.2, 28.7, and 48.4 per 1,000 person-years, respectively. There was a twofold higher fall risk when comparing the highest versus lowest quartiles for either hs-cTnT or NT-proBNP (hazard ratios, 2.17 and 2.34, respectively). When combining hs-cTnT and NT-proBNP in a joint model, the association with falls was significant and independent.

"This raises the important question of whether treatment of subclinical CVD could help prevent falls among older adults," Juraschek said in a statement.

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