Want to Live Longer? Focus on Heart Health to Avoid Falls

With Erin D. Michos, MD, MHS, and Dalane Kitzman, MD

Keeping your cardiovascular system as fit as possible can of course reduce your risk of heart attack and stroke. But that's not all having a healthy heart can do for you. If you are in tip-top cardio shape, you are also reducing the risk of falls in your later years.1

This matters because deaths from falls has increase 31% over the last decade in people 64 years of age and older, and with it comes a loss of independent, and ultimately, an increased rate of deaths.2

Adopt strategies that will reduce your risk of falling as a sure way to live longer. 2 new proteins predict risk of poor heart health, leading to a shortened lifespan, but you can take some steps to reduce your risk of falls. Photo: 123rfWhile, at first glance, the link between heart health and falls may seem to make no sense, the connection is actually quite compelling, says study co-author Erin Micos, MD, MHS, associate director of preventive cardiology and associate professor of medicine at Johns Hopkins Medicine in Baltimore, Maryland.

Link Between Heart Disease and Falling Becomes Stronger Sign of Future Health

Reducing falls, especially in the later years, is important, since falling frequently leads to bone fractures and other problems that too often send people into a downward spiral of failing health.2

In this study led by Dr. Micos, the researchers found that even people with very early or very, very mild indications of heart disease—people who do not have a diagnosis of heart disease but who have subtle signs of cardiovascular changes—have a much higher risk of falling than those whose tests did not reveal those co-called subclinical signs.1

To put these new findings into perspective, experts already know that 1 in 3 adults in the United States who reach age 65 years annually will likely encounter a fall, and the number of deaths attributed to these common falls is growing.3-5

For years, doctors have known that having a diagnosis of heart disease, meaning you have some level of clogged arteries, is linked with a greater fall risk. There are a number of factors involved, says Dr. Micos.

"It could be because older patients tend to be sicker, and less active, so they are deconditioned," she tells EndocrineWeb, meaning they are out of shape. That is very likely to set them up for future falls, she says. A properly functioning cardiovascular system assures that you have enough blood reaching all of your muscles when you are active, and that helps you to maintain your balance.1

High Level of 2 Cardiac Proteins Hints ar Greater Risk of Falls

Dr. Michos and her team wanted to if even a hint of cardiovascular loss might be enough to also increase the risk of falling. To determine this, they ran blood tests on nearly 4,000 men and women,  looking at 2 markers that reflect subtle heart disease—what she calls ''subclinical CVD (cardiovascular disease)."  

They were looking at measures of protein levels, specifically high-sensitivity cardiac troponin T (hs-CTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). These are two factors are known to represent a person’s heart health. 

In particular, NT-proBNP is a marker of early heart failure. "When the hart is stretched, it starts releases the protein called NT-proBNP," she says. "When the heart is injured, such as with a heart attack, troponin (hs-cTnT) is elevated."

The study participants were an average age of 76 years and were followed for 4-1/2 years; over that time, 457 people experienced a fall.

The researchers divided the blood test results into four groups from lowest to highest, comparing the protein levels in those who did not fall to those who tumbled to the ground. When they compared the highest marker levels to the lowest measures of either protein, they found that individuals with the highest protein levels had more than a two-fold greater risk of falling.1

These two blood tests provide a very good, early sign of cardiovascular concerns, Dr. Michos tells EndocrineWeb, and may prove useful as a warning sign of future falls.

Preventing Heart Disease Brings Better Balance, Longer Life

In a discussion about the study findings, cardiologists from Wake Forest School of Medicine in Winston-Salem, North Carolina, tell the story of a former patient who, at 95 years of age, was clearly ahead of his time.6 This gentleman, an entrepreneur who still ran his own large business, had never had a heart attack or other cardiovascular event. Even so, he insisted on seeing his cardiologist every year for a check-up.

His cardiologist asked him to share his secret for his good health to which the patient answered immediately: "Don't fall!'' The heart expert, persisted, asking why the patient insisted on seeing a heart specialist when he had no diagnosed cardiovascular problems.

The man explained that nearly all his friends and family who had passed away, and there were many at this point, had died after taking a fall. Even without any medical training, he knew enough to attribute his excellent cardiovascular status to his fitness and maintaining healthy arteries. He somehow understood somehow knew his cardiovascular system was key to fall prevention and many other aspects of health.6

His wisdom seems to support the results of this latest study, says Dalane W. Kitzman, MD, professor of cardiovascular medicine at Wake Forest, who co-authored the editorial. The important message for individuals who are looking to age well, he tells EndocrineWeb, is that even the smallest efforts against heart health may increase your risk of falling, and that will likely lead to a shortened lifespan.

Read More: Learn about the Heart and Your Thyroid

"To me, the upshot of these findings is to provide yet another reason for a person to be particularly careful about maintaining cardiovascular health and minimizing risk," Dr. Kitzman says. This means being active, if just taking a walk every day, and eating more plant-based foods instead of fast food, fried foods, and processed products.

This message is extremely and especially important for anyone with diabetes, Dr. Kitzman says, emphasizing that anyone with diabetes ''has enormous risk for cardiovascular damage," so the need to commit to heart healthy living is essential.

The Dos and Don’ts of Heart Health—Life’s Simple 7

Here's what you should NOT do—rush to your doctor and ask for these blood tests. "The message is not to ask your doctor to be tested for subclinical CVD," Dr. Kitzman says.  

Dr. Michos agrees: "The message is not to run out and insist on having these blood tests." Having the results of these tests, she tells EndocrineWeb, will not change her advice to people to manage their risk factors, such as high blood pressure and high cholesterol. Rather, your goal should be to do whatever you can to prevent cardiovascular disease from developing in the first place.

Both Dr. Kitzman and Dr. Michos strongly suggest that you follow "Life's Simple 7." This is the advice given by the American Heart Association/American Stroke Association,7 which highlights basic strategies that guide you to track and assess your personal heart health so you can get a better grasp of your risks of heart disease and stroke so you can also reduce your risk of a life-threatening fall.

How many of the 7 Simple Heart Health Tips do you follow?7

1. Check your blood pressure.  Having blood pressure in the normal range reduces strain on the heart, arteries and kidneys—and that boosts health.

2. Keep your cholesterol in check. Blood cholesterol levels contributes to a build-up of plaque in the arteries, and as these arteries to your heart and brain become clogged, your risk of developing heart disease and stroke increase.

3. Know your blood sugar. Having high blood sugar levels is the most obvious sign of diabetes, which will damage the heart, kidneys, eyes, liver, and nerves. And if you have diabetes, redouble your efforts to achieve a blood sugar that stays in a healthy range more often.

4. Be active. Regular physical activity increases not just the quality of your life but will extend your life with a strong heart, capable muscles, and a strong blood supply to every organ including your brain. And, is the key to maintaining good balance and flexibility which reduces the risk of falls as you age.

5. Eat Mediterranean. A heart-healthy diet may take many forms but all focus on increasing the amount of fruit and vegetables, choosing unsaturated fats from olives, avocados, and nuts, having limited whole grains, with a little fish and lean meat.

6. Strive for a healthier weight. If you need to, lose some excess weight to reduce the burden and stress that added fat around your heart and other central organs, lungs, blood vessels and skeleton. 

7. Don’t smoke. If you still do, there are new ways to help you quit, and quit you should. Cigarette smoking remains a big driver of heart disease, and many other quality and quantity of life issues.

Pick one of the heart-promoting goals that you do not yet do, and commit to finding ways to make some changes that will bring you closer to better heart health.


Neither Dr. Kitzman nor Dr. Michos have any relevant financial disclosures.

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