# Vitamin D, Subclinical Cardiovascular Disease, and Orthostatic Hypotension in Older Adults

> **NIH NIH K23** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $100,547

## Abstract

Each year, nearly one third of adults aged 65 years or older experiences a fall and the rate of falls in the US is
rising. Older adults frequently do not recover from falls, resulting in permanent disability and premature death.
Given the aging US population, identifying mechanisms by which falls occur and interventions to prevent falls
are recognized public health priorities. This proposal focuses on an innovative hypothesis that undetected or
subclinical cardiovascular disease (CVD), a condition highly prevalent in older adults, may contribute to falls in
older adults. Our scientific premise is based on our recently published work in middle-aged adults, which
demonstrated that subclinical CVD was strongly associated with orthostatic hypotension, a fall risk factor.
Given the essential role of the cardiovascular system to support functions of both muscle and the central
nervous system, we believe that CVD might promote falls in several ways beyond orthostasis, including muscle
strength, gait speed, and balance, and that elevations in markers of subclinical CVD would be associated with
a higher risk of falling. However, these pathways have not been tested in a population of older adults.
This supplement proposal aims to (1) determine the contribution of subclinical CVD toward the pathogenesis of
falls via orthostatic hypotension, and (2) determine the impact of vitamin D3 supplementation, an intervention
for falls, on subclinical CVD. We will accomplish these aims by measuring subclinical CVD via two reliable and
highly sensitive markers of cardiovascular injury and strain: high sensitivity cardiac troponin I (hs-cTnI) and N-
terminal pro b-type natriuretic peptide (NT-proBNP) in stored specimens of the NIA-funded trial (STURDY).
STURDY tests the effects of vitamin D3 supplementation on falls in high-risk adults, age 70 and older, and
includes detailed assessments of muscle strength, gait speed, and balance along with comprehensive
assessments of orthostatic hypotension, secondary to Dr. Juraschek's K23 ancillary proposal. Furthermore,
STURDY's randomized design, which involves one of four vitamin D3 doses administered to adults with
insufficient or deficient vitamin D, affords a tremendous opportunity to determine the direct effects of
appropriately dosed vitamin D3 on subclinical CVD.
This innovative proposal brings together (1) an expert team of STURDY investigators on orthostatic
hypotension, supplements, and the measurement of CVD biomarkers (Drs. Juraschek, Appel, Christenson), (2)
an ongoing industry partnership with Siemens which significantly reduces assay costs, (3) an incredibly unique
and established NIA study population, and (4) a remarkable track record of productivity.
This proposal has the potential to shift paradigms in how orthostatic hypotension is understood and establish
subclinical CVD as a critical focus of subsequent fall prevention strategies. Furthermore, our proposal will
provide definitive evidence as to whether one fa...

## Key facts

- **NIH application ID:** 10305928
- **Project number:** 3K23HL135273-06S1
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** STEPHEN P JURASCHEK
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $100,547
- **Award type:** 3
- **Project period:** 2017-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10305928

## Citation

> US National Institutes of Health, RePORTER application 10305928, Vitamin D, Subclinical Cardiovascular Disease, and Orthostatic Hypotension in Older Adults (3K23HL135273-06S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10305928. Licensed CC0.

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