Grip strength may predict risk of stroke, heart attack and death

A large international study has associated weak grip strength with increased risk of heart attack and stroke, as well as increased risk of death from both cardiovascular and noncardiovascular diseases.

Every 5 kg reduction in grip strength was linked to a 9% higher risk of stroke and a 7% greater risk of heart attack in the study.

Researchers at the Population Health Research Institute, Hamilton Health Sciences and McMaster University in Canada published their findings in The Lancet.

Based on their findings, the team says a grip strength test could be used as a rapid, low-cost screening tool for health care professionals to identify patients at high risk of severe illness, as well those at high risk of death from such conditions.

Numerous studies have linked reduced muscular strength - as determined by grip strength - to greater risk of health conditions, disability and premature death.

However, the researchers say few of these studies have provided data on how grip strength may be a predictor of disease prognosis, and many studies have only focused on specific high-income countries.

For their research, the investigators analyzed data of 139,691 adults aged 35-70 who were a part of The Prospective Urban-Rural Epidemiology (PURE) study.

Participants were from 17 low- and high-income countries - including Canada, Sweden, India, South Africa and Poland - and were followed for an average of 4 years.

The grip strength of all participants was measured using a handgrip dynamometer.

Every 5 kg reduction in grip strength increases death risk by up to 17%

The researchers found that for every 5 kg reduction in grip strength, participants were at 16% greater risk of all-cause death, 17% high risk of cardiovascular death and 17% increased risk of non-cardiovascular death.

In addition, the team found that every 5 kg reduction in grip strength among the participants was linked to a 9% higher risk of stroke and a 7% greater risk of heart attack.

Among participants who developed both cardiovascular and noncardiovascular diseases, low grip strength was linked to greater risk of death. This, the researchers say, indicates that grip strength could predict mortality risk among individuals with severe illness.

The team says their findings remained even after accounting for factors that may influence cardiovascular conditions and mortality, including age, employment status, education level, physical activity level, smoking status and alcohol use.

"Grip strength could be an easy and inexpensive test to assess an individual's risk of death and cardiovascular disease. Further research is needed to establish whether efforts to improve muscle strength are likely to reduce an individual's risk of death and cardiovascular disease."

Commenting in an editorial linked to the study, another team of clinical investigators at the University of Southampton, and at Newcastle University - both in the UK - say that while these findings are not new, they provide further evidence that grip strength may be a predictor of illness and early death.

Loss of grip strength is unlikely to lie on a single final common pathway for the adverse effects of aging, but it might be a particularly good marker of underlying aging processes, perhaps because of the rarity of muscle-specific diseases contributing to change in muscle function.

References:

1.  Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study, Darryl Leong, et al., The Lancet, doi: http://dx.doi.org/10.1016/S0140-6736(14)62000-6, published online 14 May 2015.
2.  The Lancet news release, accessed 13 May 2015 via AlphaGalileo.