The association of handgrip strength with all-cause and cardiovascular mortality: results from the National Health and Nutrition Examination Survey database prospective cohort study with propensity score matching

Abstract

ObjectiveTo investigate the association between handgrip strength (HGS) with all-cause and cardiovascular disease (CVD) mortality in US adults.MethodWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) prospective cohort study (2011–2014) with 10,470 participants. The cox regression analysis, Kaplan–Meier survival curves, fitted curves, ROC curves, and propensity score-matched analysis (PSM) with inverse probability of treatment weighting (IPTW), SMRW (PSM with repeated weights), PA (pairwise algorithm), and OW (overlap weighting) regression analysis were performed to assess the relationship between HGS and all-cause and CVD mortality.ResultsThe low HGSs (men <37.4 kg, women <24 kg), was found to be associated with higher all-cause and CVD mortality in a reverse J-shaped curve (p < 0.05). Adjusting for multiple covariates including age, BMI, race, education level, marriage status, smoking and alcohol use, and various comorbidities, the hazard ratio (HR) for all-cause mortality in the lowest HGS quintile 1 (Q1) was 3.45 (2.14–5.58) for men and 3.3 (1.88–5.79) for women. For CVD mortality, the HR was 2.99 (1.07–8.37) for men and 10.35 (2.29–46.78) for women. The area under the curve (AUC) for HGS alone as a predictor of all-cause mortality was 0.791 (0.768–0.814) for men and 0.780 (0.752–0.807) for women (p < 0.05), while the AUC for HGS and age was 0.851 (0.830–0.871) for men and 0.848 (0.826–0.869) for women (p < 0.05). For CVD mortality, the AUC for HGS alone was 0.785 (95% CI 0.738–0.833) for men and 0.821 (95% CI 0.777–0.865) for women (p < 0.05), while the AUC for HGS and age as predictors of all-cause mortality was 0.853 (0.861–0.891) for men and 0.859 (0.821–0.896) for women (p < 0.05). The HGS Q1 (men <37.4 kg and women <24 kg) was matched separately for PSM. After univariate, multivariate Cox regression models, PSM, IPTW, SMRW, PA, and OW analyses, women had 2.37–3.12 and 2.92–5.12 HRs with low HGS for all-cause and CVD mortality, while men had 2.21–2.82 and 2.33–2.85 for all-cause and CVD mortality, respectively (p < 0.05).ConclusionAdults with low HGS exhibited a significantly increased risk of both all-cause and CVD mortality, regardless of gender. Additionally, low HGS served as an independent risk factor and predictor for both all-cause and CVD mortality.

Association of Handgrip Strength with Hip Fracture and Falls in Community‐dwelling Middle‐aged and Older Adults: A 4‐Year Longitudinal Study

“…Handgrip strength (HGS) is widely recognized as an indicator of overall muscle strength and functional status, providing a valuable tool for assessing musculoskeletal health and predicting adverse health outcomes. Our previous research indicated a significant correlation between low HGS and an increased risk of all‐cause mortality and cardiovascular mortality in the American population 7 . Furthermore, we have identified a causal relationship between HGS and all‐cause mortality based on a Genome‐wide association study analysis of a population of 1.1 million Europeans 8 .…”

“…Our previous research indicated a significant correlation between low HGS and an increased risk of all‐cause mortality and cardiovascular mortality in the American population. 7 Furthermore, we have identified a causal relationship between HGS and all‐cause mortality based on a Genome‐wide association study analysis of a population of 1.1 million Europeans. 8 Additionally, HGS serves as a predictor of hip fracture recovery and is associated with falls and fractures in older adults.…”

Glyphosate exposure, muscular health and functional limitations in middle-aged and older adults.

“…Skeletal muscle plays a critical role in maintaining physical function and metabolic health (Wolfe, 2006). In this regard, a growing number of studies reveal that, in both middle-aged and older adults, strength and muscle mass are inversely associated with increased risk of chronic health problems such as diabetes (Moon, 2014;Kunutsor et al, 2021a;Boonpor et al, 2021), cardiovascular disease (Tyrovolas et al, 2020;Lopez-Jaramillo et al, 2022;Peralta et al, 2023), cognitive impairments (Filardi et al, 2022;Tessier et al, 2022;Prokopidis et al, 2023), falls (Landi et al, 2012;Reijnierse et al, 2019), bone fractures (Kunutsor et al, 2021b), disability (Abay et al, 2022), as well as all-cause and cause-specific mortality (López-Bueno et al, 2022;Landi et al, 2022;Xiong et al, 2023). In general, muscle strength is a better predictor of adverse health outcomes than muscle mass (Cruz-Jentoft et al, 2019).…”