A simple strength-to-weight measure may flag cardiovascular disease and mortality risk in middle-aged and older adults. Digest
Age-related declines in muscle strength occur alongside rising burdens of heart disease and premature death, yet clinicians lack simple physical tests that identify the highest-risk patients. In a new study, a research team asked whether a quick measure that combines handgrip strength with body weight could help close this gap.
The investigators analyzed data from more than 10,000 U.S. adults and over 11,000 Chinese adults. They calculated a grip strength-to-weight ratio by adding the strongest reading from each hand and dividing it by the participant's body weight. Participants were grouped into four categories based on this ratio and followed for several years to track deaths. Cardiovascular disease was captured at the start of the study through standardized questions about previous medical diagnoses.
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Here's what the researchers observed:
- Across both cohorts, adults in higher grip strength-to-weight quartiles had substantially lower rates of death from any cause than those in the lowest quartile, with the highest quartile showing a 73% lower risk in U.S. adults and nearly a 47% lower risk in Chinese middle-aged and older adults.
- In U.S. adults, the same pattern held for deaths from cardiovascular causes, with the highest quartile having a 79% lower risk than the lowest quartile.
- People in the higher quartiles had roughly a 30 to 40% lower prevalence of cardiovascular disease than those in the lowest quartile.
- In dose–response analyses, the risk fell sharply as the ratio increased from low values and then leveled off once a moderate level was reached, with protective effects beginning around 0.9 in the U.S. and 1.06 in China, and little further benefit beyond those points.
- When the U.S. cohort was divided by age and sex, grip strength-to-weight predicted mortality and cardiovascular disease only in adults aged 45 years and older, and associations tended to be stronger in men than in women.
These results suggest that the grip strength-to-weight ratio reflects aspects of muscle quantity and function that relate closely to cardiometabolic health. Skeletal muscle is a major site for glucose use and influences inflammatory signaling, so a low ratio may reflect poorer metabolic control and persistent low-grade inflammation, which in turn can promote cardiovascular events and early death.
The exclusion of people with missing grip strength or mortality data may have skewed the results, and differences in measurement protocols plus the observational design limit causal interpretation. Still, adding the grip strength-to-weight ratio as an inexpensive, non-invasive measure in routine clinical assessments could help clinicians identify higher-risk middle-aged and older adults who may benefit from strength training and other lifestyle interventions. Episode #78 of the FoundMyFitness podcast features a conversation between Dr. Brad Schoenfeld and me on using resistance training to improve strength, enhance body composition, maximize hypertrophy, and train efficiently.