Getting A Grip On Mortality

There are many clinical measures that predict increased risk of cardiovascular and all-cause mortality (e.g. having a high blood pressure).

However, it turns out that perhaps one of the most powerful predictors of mortality is a simple and inexpensive assessment of grip strength – something rarely assessed in clinical practice.

Now, a study by Darryl Leung and colleagues, in a paper published in The Lancet, reports that grip strength does just that.

The paper presents data from the Prospective Urban-Rural Epidemiology (PURE) study, a large, longitudinal population study done in 17 countries of varying incomes and sociocultural settings involving nearly 150,000 individuals.

During a median follow-up of 4·0 years, grip strength (as a simple measure of muscular strength) was found to be inversely associated with all-cause mortality (hazard ratio per 5 kg reduction in grip strength 1·16), cardiovascular mortality (1·17), non-cardiovascular mortality (1·17), myocardial infarction (1·07), and stroke (1·09).

In fact, grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure.

In contrast, grip strength was not associated with diabetes, hospital admission for pneumonia or COPD, injury from fall, or fracture.

Interestingly, the association between grip strength and cardiovascular mortality is not new – however, the association with all-cause mortality and the consistency of this findings across populations and economic strata is remarkable.

Obviously, these findings beg the question whether increasing grip strength (or rather muscular strength in general) through resistance training and adequate protein intake will lower mortality – a question that would take a rather large randomised controlled study to answer.

Till then, it is prudent to remember that association does not prove causation – it would thus be premature to conclude that your weak handshake is killing you.

@DrSharma
Edmonton, AB