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Association between handgrip strength and mortality risk among cardiovascular disease patients: A cohort study from
Zhengjie Qin1, Youhua Guo1, Weilin Yang2
1Rehabilitation Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road No.111, Guangzhou, Guangdong, 510120, China.
Insights
Low handgrip strength (HGS) significantly increases mortality risk in cardiovascular disease (CVD) patients. Conversely, high HGS may reduce mortality risk, suggesting HGS is a valuable predictor for CVD patients.
Area of Science:
- Cardiology
- Public Health
- Gerontology
Background:
- Cardiovascular disease (CVD) and low handgrip strength (HGS) are established mortality risk factors.
- The combined impact of CVD and HGS on mortality requires further investigation.
Purpose of the Study:
- To investigate the relationship between handgrip strength and mortality in patients with cardiovascular disease.
- To determine if handgrip strength can serve as a predictor of mortality in CVD patients.
Main Methods:
- Analysis of data from the National Health and Nutrition Examination Survey (2011-2014).
- Utilized weighted Cox proportional hazards models and restricted cubic splines (RCS) for association analysis.
- Included subgroup, sensitivity, and predictive performance analyses.
Main Results:
- Among 8,262 adults, 851 had CVD. Low HGS in CVD patients was linked to the highest risk of all-cause and CVD mortality compared to non-CVD individuals with high HGS.
- CVD patients with low HGS exhibited significantly higher risks for all-cause (HR=3.60) and CVD mortality (HR=4.01).
- Handgrip strength addition improved the predictive performance of existing mortality models (P < 0.001).
Conclusions:
- Low handgrip strength is associated with increased all-cause and CVD mortality risk in CVD patients.
- High handgrip strength appears to mitigate mortality risk among individuals with cardiovascular disease.
- Handgrip strength shows potential as a valuable prognostic tool for mortality risk assessment in CVD patients.
Background:
Cardiovascular disease (CVD) and handgrip strength (HGS) are recognized mortality risk factors. However, the synergistic effect of CVD and HGS on mortality remains unclear. This study investigated the relationship between HGS and mortality in CVD patients.
Methods:
Data from the National Health and Nutrition Examination Survey (2011-2014) were analyzed. Weighted Cox proportional hazards models and restricted cubic splines (RCS) were used to examine associations, with subgroup, sensitivity and predictive performance analyses.
Results:
Among 8,262 adults (50.56% female; 851 with CVD), 695 deaths (6.74%) occurred over a median follow-up of 80 months. Compared to non‒CVD individuals with high-HGS, CVD patients with low-HGS had the highest risk of all-cause mortality [hazard ratio (HR) = 8.76; 95% CI: 4.20-18.30] and CVD mortality (HR = 4.83; 95% CI: 3.48-6.70), while CVD patients with high-HGS showed no significant mortality risk increase. Among CVD patients, the HRs for all-cause and CVD mortality in the low-HGS group were 3.60 (95% CI, 2.21-5.86) and 4.01 (95% CI, 1.68-9.59). RCS analyses revealed that the relationships were linear (P‒nonlinear >0.05), and subgroup analyses revealed stroke status potentially modified the association for CVD mortality (P‒interaction = 0.002). The addition of HGS significantly improved the predictive performance of current models for mortality (P < 0.001).
Conclusion:
Low HGS may be associated with a higher risk of all-cause and CVD mortality among CVD patients. High HGS appears to reduce mortality risk among CVD patients. These findings suggest that HGS may serve as a valuable predictor of mortality risk in CVD patients.
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