While traditional cardiovascular disease risk factors such as high blood pressure, high cholesterol, smoking or diabetes are closely linked to cardiovascular disease, particularly in middle-aged people, we also know these factors may not be as predictive in older adults, so we need to identify nontraditional predictors for older adults

New research published today in the Journal of the AHA found that having reduced physical function was independently associated with an increased risk of heart attack, heart failure, and stroke.

In this analysis, physical function was measured using the Short Physical Performance Battery (SPPB), which assesses things like walking pace, leg strength, and balance. In contrast to physical fitness, this study focused on physical function.

“While traditional cardiovascular disease risk factors,” according to study senior author Kunihiro Matsushita, “such as high blood pressure, high cholesterol, smoking or diabetes are closely linked to cardiovascular disease, particularly in middle-aged people, we also know these factors may not be as predictive in older adults, so we need to identify nontraditional predictors for older adults.”

In the new analysis, the researchers “found that physical function in older adults predicts future cardiovascular disease beyond traditional heart disease risk factors, regardless of whether an individual has a history of cardiovascular disease.”

During the years 1987–1989, researchers enrolled 15,792 adults in the Atherosclerosis Risk in Communities (ARIC) study, a community-based cohort studying the origins of atherosclerotic disease in people aged 45–64. (plaque or fatty buildup in the arteries). Check-ins were done once a year and, starting in 2012, every six months. They included phone calls and clinic visits.

In this study, health information from ARIC visit 5 (2011–2013; all participants were over 65) was used as a baseline. This is when the SPPB physical function test was first taken. The SPPB gave people a score based on how fast they could walk, how quickly they could get out of a chair without using their hands, and how well they could stand up straight.

Researchers examined health information for 5,570 adults, with an average age of 75 and a gender distribution of 58% women, 78% white adults, and 22% Black adults. Based on their performance on the test, the participants’ physical function was divided into three groups using their SPPB scores: low, middle, and high.

After controlling for important cardiovascular disease risk factors like high blood pressure, smoking, high cholesterol, diabetes, and a history of cardiovascular disease, researchers looked at the correlation between SPPB scores and future heart attack, stroke, and heart failure as well as the composite of the three.

The study revealed:

• In terms of physical function, 13% of participants had poor scores, 30% had intermediate scores, and 57% had good scores.

• 930 research participants experienced one or more verified cardiovascular events over the course of the 8-year trial, including 386 cases of heart attack, 251 cases of stroke, and 529 cases of heart failure.

• Adults with low physical function scores were 47% more likely to have at least one cardiovascular disease event than adults with high physical function scores. Adults with intermediate physical function scores were 25% more likely to have at least one cardiovascular disease event.

• Even after accounting for established cardiovascular disease risk variables such age, high blood pressure, high cholesterol, and diabetes, the link between physical function and cardiovascular disease persisted.

• Regardless of whether a person had a history of cardiovascular disease or was in good health, the physical function score increased the risk prediction of cardiovascular disease outcomes beyond standard cardiovascular risk variables.

The results of the study, accoring to the main author, “highlight the value of assessing the physical function level of older adults in clinical practice. In addition to heart health, older adults are at higher risk for falls and disability. The assessment of physical function may also inform the risk of these concerning conditions in older adults.”

Older persons who experience falls or fear of falling are more likely to have serious injuries, incur substantial medical expenses, and experience significant reductions in quality of life. Preventing and managing falls in adults with cardiovascular disease, a scientific statement from the American Heart Association from 2022, recommends medication adjustments, reevaluating treatment regimens, taking into account non-drug treatment options, and properly managing heart rhythm disorders to lower the risk of falls in elderly adults.

“Our study adds additional evidence to past research, which has demonstrated the importance of maintaining physical function at an older age,” Matsushita adds. “The next questions are: what is the best way for older adults to maintain physical function, and whether interventions that improve physical function can reduce cardiovascular disease risk?”

The research had several limitations. Adults from only two racial or ethnic groups—White and Black—were included in the study population (ARIC began enrollment in 1985, when participation among people from diverse racial and ethnic backgrounds was more limited). Additionally, the study did not take into consideration people whose limited mobility would prohibit them from being evaluated at a research clinic. The findings will need to be confirmed in individuals from more diverse racial and ethnic groupings as well as individuals with even lower levels of physical function.

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You were reading: Three Unique Signs People After 65 Are At Greater Risk of Heart Failure and Stroke