Jari A Laukkanen1, Hassan Khan2, Carl J Lavie3, Ari Voutilainen4, Sudhir Kurl4, Sae Young Jae5, Setor K Kunutsor6. 1. Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio; Central Finland Health Care District Hospital District, Jyväskylä. Electronic address: jariantero.laukkanen@uef.fi. 2. Center for the Prevention of Cardiovascular Disease, The Leon H. Charney Division of Cardiology, NYU Langone Health, NYU Robert I. Grossman School of Medicine, New York, NY. 3. John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA. 4. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio. 5. Department of Sport Science, University of Seoul, Republic of Korea; Graduate School of Urban Public Health, University of Seoul, Republic of Korea. 6. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, United Kingdom; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, United Kingdom.
Abstract
OBJECTIVE: To evaluate the nature, magnitude, and specificity of the association between handgrip strength (HGS) and heart failure (HF) risk. PATIENTS AND METHODS: Handgrip strength was assessed at baseline from March 1, 1998, to December 31, 2001, by use of a hand dynamometer in the Finnish Kuopio Ischemic Heart Disease prospective population-based cohort of 770 men and women aged 61 to 74 years without a history of HF. Relative HGS was obtained by dividing the absolute value by body weight. Hazard ratios (HRs) with 95% CIs were estimated with Cox regression models. We used multiple imputation to account for missing data. RESULTS: During a median (interquartile range) follow-up of 17.1 (11.3-18.3) years, 177 HF events were recorded. Handgrip strength was continually associated with risk of HF, consistent with a curvilinear shape. On adjustment for several established risk factors and other potential confounders, the HR (95% CI) for HF was 0.73 (0.59-0.91) per 1 SD increase in relative HGS. Comparing the top vs bottom tertiles of relative HGS, the corresponding adjusted HR was 0.55 (0.38-0.81). The association remained similar across several clinical subgroups. Imputed results were broadly similar to the observed results. CONCLUSION: Relative HGS is inversely and continually associated with the future risk of HF in the general population. Studies are warranted to evaluate whether HGS may be a useful prognostic tool for HF in the general population and to determine whether resistance exercise training may lower the risk of HF.
OBJECTIVE: To evaluate the nature, magnitude, and specificity of the association between handgrip strength (HGS) and heart failure (HF) risk. PATIENTS AND METHODS: Handgrip strength was assessed at baseline from March 1, 1998, to December 31, 2001, by use of a hand dynamometer in the Finnish Kuopio Ischemic Heart Disease prospective population-based cohort of 770 men and women aged 61 to 74 years without a history of HF. Relative HGS was obtained by dividing the absolute value by body weight. Hazard ratios (HRs) with 95% CIs were estimated with Cox regression models. We used multiple imputation to account for missing data. RESULTS: During a median (interquartile range) follow-up of 17.1 (11.3-18.3) years, 177 HF events were recorded. Handgrip strength was continually associated with risk of HF, consistent with a curvilinear shape. On adjustment for several established risk factors and other potential confounders, the HR (95% CI) for HF was 0.73 (0.59-0.91) per 1 SD increase in relative HGS. Comparing the top vs bottom tertiles of relative HGS, the corresponding adjusted HR was 0.55 (0.38-0.81). The association remained similar across several clinical subgroups. Imputed results were broadly similar to the observed results. CONCLUSION: Relative HGS is inversely and continually associated with the future risk of HF in the general population. Studies are warranted to evaluate whether HGS may be a useful prognostic tool for HF in the general population and to determine whether resistance exercise training may lower the risk of HF.