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Grip Strength and Walking Pace and Cardiovascular Disease Risk Prediction in 406,834 UK Biobank Participants
Claire E Welsh1, Carlos A Celis-Morales1, Frederick K Ho2
1Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
Insights
Adding grip strength and walking pace to cardiovascular disease (CVD) risk scores significantly improves prediction accuracy. These simple measures enhance risk assessment, offering a valuable tool for early detection and prevention strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Biostatistics
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- Established CVD risk scores often rely on traditional risk factors.
- There is a need for improved predictive models incorporating accessible biomarkers.
Purpose of the Study:
- To evaluate if grip strength and walking pace enhance existing CVD risk scores.
- To determine the predictive utility of these simple physical measures in CVD risk assessment.
Main Methods:
- Utilized UK Biobank data from 406,834 participants without baseline CVD.
- Employed Cox models to assess associations of grip strength and walking pace with CVD outcomes.
- Measured predictive improvement using changes in C-index and net reclassification index.
Main Results:
- Both grip strength and walking pace showed inverse associations with CVD outcomes.
- Adding grip strength, walking pace, or both significantly improved the C-index and net reclassification index for CVD risk prediction.
- An additive benefit was observed when both grip strength and walking pace were combined.
Conclusions:
- Grip strength and walking pace are valuable additions to established CVD risk scores.
- These easily administered measures can enhance CVD risk screening and prediction.
- Further external validation is recommended before widespread clinical implementation.
Objective:
To investigate whether the addition of grip strength and/or self-reported walking pace to established cardiovascular disease (CVD) risk scores improves their predictive abilities.
Patients And Methods:
A total of 406,834 participants from the UK Biobank, with baseline measurements between March 13, 2006, and October 1, 2010, without CVD at baseline were included in this study. Associations of grip strength and walking pace with CVD outcomes were investigated using Cox models adjusting for classical risk factors (as included in established risk scores), and predictive utility was determined by changes in C-index and categorical net reclassification index.
Results:
Over a median of 8.87 years of follow-up (interquartile range 3, 8.25-9.47 years), there were 7274 composite fatal/nonfatal events (on the basis of the American College of Cardiology/American Heart Association [ACC/AHA] outcome) and 1955 fatal events (on the basis of the Systematic Coronary Risk Evaluation [SCORE] risk score). Both grip strength and walking pace were inversely associated with CVD outcomes after adjusting for classical risk factors. Addition of grip strength (change in C-index: ACC/AHA, +0.0017; SCORE, +0.0047), usual walking pace (ACC/AHA, +0.0031; SCORE, +0.0130), and both combined (ACC/AHA, +0.0041; SCORE, +0.0148) improved the C-index and also improved the net reclassification index (grip, +0.55%; walking pace, +0.53%; combined, 1.12%).
Conclusion:
The present study has found that the addition of grip strength or usual walking pace to existing risk scores results in improved CVD risk prediction, with an additive effect when both are added. As both these measures are cheap and easy to administer, these tools could provide an important addition to CVD risk screening, although further external validation is required.