Key result
Participants in the lowest quartile of dominant handgrip strength had a significantly higher risk of new-onset stroke compared to the highest quartile (HR 1.46 to 2.10 across three global cohorts).
Why the study?
Stroke and heart disease are major contributors to the global disease burden, leading researchers to evaluate and compare the roles of different handgrip strength expressions in predicting both conditions across three nationally representative cohorts.
Does lower handgrip strength predict new-onset stroke and heart disease in middle-aged and older populations?
Cohort (n=96,263)
Yes
Does lower handgrip strength predict new-onset stroke and heart disease in middle-aged and older populations?
Hazard Ratio: 1.46 (95% CI 1.3–1.62)
p-value: p=<0.001
Lower handgrip strength is an independent predictor of new-onset stroke across European, American, and Chinese populations, regardless of how it is expressed.
May aid stroke risk stratification in older adults; leaves open whether it improves prediction or outcomes beyond standard factors.
BACKGROUND: Stroke and heart disease are two major contributors to the global disease burden. We aimed to evaluate and compare the roles of different handgrip strength (HGS) expressions in predicting stroke and heart disease in three nationally representative cohorts. METHODS: This longitudinal study used data from the Health and Retirement Study (HRS), the Survey of Health, Ageing, and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). The Cox proportional hazard model was applied to analyze the relationship between HGS and stroke and heart disease, and Harrell's C index was used to assess the predictive abilities of different HGS expressions. RESULTS: A total of 4,407 participants suffered from stroke and 9,509 from heart disease during follow-up. Compared with the highest quartile, participants in the lowest quartile of dominant HGS, absolute HGS and relative HGS possessed a significantly higher risk of new-onset stroke in Europe, America, and China (all P < 0.05). After adding HGS to office-based risk factors, there were minimal or no differences in the increases of Harrell's C indexes among three HGS expressions. In contrast, the modest association between HGS and heart disease was only seen in SHARE and HRS, but not in CHARLS. CONCLUSION: Our findings support that HGS can be used as an independent predictor of stroke in middle-aged and older European, American and Chinese populations, and the predictive ability of HGS may not depend on how it is expressed. The relationship between HGS and heart disease calls for further validation.
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Li et al. (2023) conducted a cohort in Stroke and heart disease (n=96,263). Low handgrip strength vs. Highest quartile of handgrip strength was evaluated on New-onset stroke (SHARE cohort, lowest vs highest quartile of dominant handgrip strength) (HR 1.46, 95% CI 1.30-1.62, p=<0.001). Participants in the lowest quartile of dominant handgrip strength had a significantly higher risk of new-onset stroke compared to the highest quartile (HR 1.46 to 2.10 across three global cohorts).
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