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

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% confidence intervals (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 Harrell’s C-index (C-index change: 0.0034; p =.65), integrated-discrimination–improvement (0.0059; p =.20) and net-reclassification-improvement (–1.31%; p =.74); however, there was a significant difference in –2 log likelihood (p