CardioExchange Archive

A large global study finds that grip strength is a simple, powerful, and broadly applicable test that can help predict the risk of death and cardiovascular disease. The new findings from the Prospective Urban-Rural Epidemiology (PURE) study were based on data from nearly 140,000 adults in 17 countries. The study participants had their grip strength measured with a handgrip dynamometer and were followed for roughly 4 years.

The results, published in the Lancet, show that grip strength is an even stronger predictor of death than systolic blood pressure. After adjustment for other factors, every 5-kg decrease in grip strength was linked to a 16% increase in death overall, a 17% increase in both cardiovascular and non-cardiovascular mortality, a 7% increase in the risk of myocardial infarction, and a 9% increase in the risk of stroke. The findings were broadly consistent across different countries and economic levels.

An unexpected finding was that grip strength was a more powerful predictor of cardiovascular mortality than of incident cardiovascular disease. This, the authors write, “suggests that low grip strength is associated with increased susceptibility to cardiovascular death in people who do develop cardiovascular disease.” A similar pattern was observed for non-cardiovascular diseases, suggesting that “low muscle strength might not play a major causal part in the occurrence of cancer, falls, fractures, or the need for hospital admission for respiratory illnesses, but that, as with incident cardiovascular disease, low muscle strength predisposes to a fatal outcome if these non-cardiovascular diseases develop.”

In an accompanying comment, Avan Aihie Sayer and Thomas B L Kirkwood write that the results, taken with previous research, mean that “there can be no doubt that grip strength predicts future all-cause mortality.” “Grip strength,” they write, “might act as a biomarker of ageing across the life course,” while “loss of grip strength … might be a particularly good marker of underlying aging processes.”

The lead author of the study, Dr Darryl Leong, said that “grip strength could be an easy and inexpensive test to assess an individual’s risk of death and cardiovascular disease.” He cautioned, however, that “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.”