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Cardiovascular disease (CVD) is associated with greater fall risk; however, it is unknown if pathways that contribute to CVD, such as subclinical myocardial damage or wall strain, are related to future falls. We hypothesized that elevations in high\u2010sensitivity cardiac troponin T (hs\u2010cTnT) and N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP), measured in older adults, would be associated with greater fall risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING AND PARTICIPANTS<\/jats:title>\n                    <jats:p>Atherosclerosis Risk in Communities Study participants without known coronary heart disease, heart failure, or stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>\n                      We measured hs\u2010cTnT or NT\u2010proBNP in 2011 to 2013. Falls were identified from hospital discharge\n                      <jats:italic>International Classification of Diseases, Ninth Revision<\/jats:italic>\n                      (\n                      <jats:italic>ICD\u20109<\/jats:italic>\n                      ), codes or Centers for Medicare and Medicaid Services claims. We used Poisson models adjusted for age, sex, and race\/study center to quantify fall rates across approximate quartiles of hs\u2010cTnT (less than 8, 8\u201010, 11\u201016, and 17\u2009or greater ng\/L) and NT\u2010proBNP (less than 75, 75\u2010124, 125\u2010274, and 275\u2009or greater pg\/mL). We used Cox models to determine the association of cardiac markers with fall risk, adjusted for age, sex, race\/center, and multiple fall risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 3973 participants (mean age = 76\u2009\u00b1\u20095 years, 62% women, 22% black), 457 had a subsequent fall during a median follow\u2010up of 4.5 years. Incidence rates across quartiles of hs\u2010cTnT and NT\u2010proBNP were 17.1, 20.0, 26.2, and 36.4 per 1000 person\u2010years and 12.8, 22.2, 28.7, and 48.4 per 1000 person\u2010years, respectively. Comparing highest vs lowest quartiles of either hs\u2010cTnT or NT\u2010proBNP demonstrated a greater than two\u2010fold higher fall risk, with hazard ratios of 2.17 (95% confidence interval {CI} = 1.60\u20102.95) and 2.34 (95% CI = 1.73\u20103.16), respectively. In a joint model, the relationships of hs\u2010cTnT and NT\u2010proBNP with falls were significant and independent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Subclinical elevations of cardiac damage and wall strain were each associated with a higher fall risk in older adults. Further research is needed to determine whether interventions that lower hs\u2010cTnT or NT\u2010proBNP also lower fall risk.\n                      <jats:bold>J Am Geriatr Soc 67:1795\u20131802, 2019<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16041","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T11:01:56Z","timestamp":1562756516000},"page":"1795-1802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Subclinical Cardiovascular Disease and Fall Risk in Older Adults: Results From the Atherosclerosis Risk in Communities Study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-2696","authenticated-orcid":false,"given":"Stephen P.","family":"Juraschek","sequence":"first","affiliation":[{"name":"Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Daya","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Appel","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edgar R.","family":"Miller","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Matsushita","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-5084","authenticated-orcid":false,"given":"Erin D.","family":"Michos","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine Department of Medicine, The Johns Hopkins Bloomberg School of Public Health Department of Epidemiology The Welch Center for Prevention, Epidemiology and Clinical Research, and Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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