Handgrip strength is inversely associated with fatal cardiovascular and all-cause mortality events: Handgrip strength and fatal outcomes

Jari A Laukkanen, Ari Voutilainen, Sudhir Kurl, Claudio Gil S Araújo , Sae Young Jae, Setor K Kunutsor

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction.
Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61-74 years at baseline. Relative HS was obtained by dividing the absolute value by body weight.
Results: During a median (interquartile range) follow-up of 17.3 (12.6-18.4) years, 116 fatal coronary heart diseases (CHDs), 195 fatal CVDs, and 412 all-cause mortality events occurred. On adjustment for several risk factors, the hazard ratios (95% CIs) for fatal CHD, fatal CVD, and all-cause mortality were 0.59 (0.37-0.95), 0.59 (0.41-0.86), and 0.66 (0.51-0.84) respectively comparing extreme tertiles of relative HS. Adding relative HS to a CVD mortality risk prediction model containing established risk factors did not improve discrimination or reclassification using Harrel’s C-index (C-index change: 0.0034; p=0.65), integrated-discrimination-improvement (0.0059; p=0.20), and net-reclassification-improvement (-1.31%; p=0.74); however, there was a significant difference in in -2 log likelihood (p<0.001).
Conclusion: Relative HS is inversely associated with CHD, CVD and all-cause mortality events. Adding relative HS to conventional risk factors improves CVD risk assessment using sensitive measures of discrimination.
Original languageEnglish
JournalAnnals of Medicine
Early online date30 Mar 2020
DOIs
Publication statusE-pub ahead of print - 30 Mar 2020

Keywords

  • handgrip strength
  • cardiovascular disease
  • mortality
  • risk prediction

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