Associations of handgrip strength and standing long jump performance with hypertension among children and adolescents in China

Background and purpose Handgrip strength (HGS) and standing long jump (SLJ) are widely used field tests for assessing the localized maximal isometric force and dynamic lower-body explosive performance, respectively. We compared their associations with hypertension and severe hypertension and examined the variation across body-size-related expressions. Methods We analyzed 635 677 participants aged 7–18 years from the 2010, 2014, and 2019 Chinese National Survey on Students’ Constitution and Health. Eight metrics were evaluated: absolute HGS, SLJ, and each test relative to height, weight, and body mass index (BMI). Metrics were converted to survey year-, sex-, and age-specific deficit Z -scores. Generalized linear mixed-effects models with school random intercepts adjusted for age, sex, urban-rural residence, and endurance running performance. Restricted cubic splines were used to assess nonlinear associations. Results The direction of HGS associations differed across metric expressions. Deficits in absolute and height-relative HGS were inversely associated with both outcomes, whereas deficits in weight- and BMI-relative HGS were positively associated with both. Deficits in the expression of all four SLJ were positively associated with hypertension and severe hypertension across the three survey waves, although the magnitude varied by metric. SLJ/weight, yielded the largest estimates. The odds ratios for hypertension were 1.54, 1.70, and 1.60 in 2010, 2014, and 2019, respectively; the corresponding estimates for severe hypertension were 1.88, 2.10, and 1.84. Nonlinear analyses showed progressively steeper increases in the odds of both outcomes at higher HGS/weight and SLJ/weight-deficit levels. Conclusions HGS and SLJ showed distinct metric-dependent associations with hypertension. SLJ associations were consistent across the four expressions, whereas HGS associations changed in direction. SLJ/weight, yielded the largest estimates. These findings support the consideration of SLJ along with HGS in pediatric cardiovascular research and highlight the need for clear body size scaling.