The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: Findings from the Prospective Urban Rural Epidemiology China Study

Abstract Background Hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect both CVD and all-cause mortality is unknown. The study aimed to examine whether the associations between hypertension and GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality differed between people with and without hypertension. Methods GS was measured using a Jamar dynamometer in participants aged 35–70 years from 12 provinces in the Prospective Urban Rural Epidemiology (PURE) China study. Hypertension was defined as a baseline systolic and diastolic blood pressure of at least 140/90 mm Hg, a self-reported history of hypertension, or treatment with antihypertensive medications. Cox proportional hazards models were used to examine the associations of GS and hypertension and with the outcomes of all-cause mortality and CVD incidence/mortality, and to test the multiplicative interactions between hypertension and GS. Results Among 39,862 participants included in this study, 15,964 reported having hypertension at baseline and 9095 had high GS. After a median follow-up of 8.9 years [interquartile range (IQR) 6.7–9.9 years], 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (HR 2.36 [95% CI: 1.84–3.02]; P<0.0001) or CVD mortality (HR 3.05 [95% CI: 1.56–5.95]; P<0.0001) but did not have a significantly increased risk of all-cause mortality (HR 1.23 [95% CI: 0.91–1.67]; P=0.181); these risks were further increased if hypertensive participants whose GS level was low (major CVD incidence (HR 3.33 [95% CI: 2.61, 4.24]; P<0.0001), CVD mortality (HR: 5.20 [95% CI: 2.76, 9.82]; P<0.0001), and all-cause mortality (HR 2.00 [95% CI: 1.53, 2.62]; P<0.0001)). Conclusions The present study demonstrates that hypertensive patients with low GS are associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients. Association of adverse outcomes Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The main PURE study and its components are funded by the Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, and through unrestricted grants from several pharmaceutical companies. Besides funding from global PURE, this work was also sponsored by CAMS Innovation Fund for Medical Sciences (CIFMS): 2016-I2M-2-004, Construction of Basic Information Technology Support System and Platform for National Prevention and Treatment of Cardiovascular Diseases.

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Association of Grip Strength With Risk of All-Cause Mortality, Cardiovascular Diseases, and Cancer in Community-Dwelling Populations: A Meta-analysis of Prospective Cohort Studies

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2017.03.011 ◽

2017 ◽

Vol 18 (6) ◽

pp. 551.e17-551.e35 ◽

Cited By ~ 52

Author(s):

Yili Wu ◽

Weijing Wang ◽

Tianwei Liu ◽

Dongfeng Zhang

Keyword(s):

Cardiovascular Diseases ◽

Cohort Studies ◽

Grip Strength ◽

Prospective Cohort ◽

Meta Analysis ◽

Community Dwelling ◽

Prospective Cohort Studies ◽

All Cause Mortality

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Estimated Glomerular Filtration Rate, All-Cause Mortality and Cardiovascular Diseases Incidence in a Low Risk Population: The MATISS Study

PLoS ONE ◽

10.1371/journal.pone.0078475 ◽

2013 ◽

Vol 8 (10) ◽

pp. e78475 ◽

Cited By ~ 22

Author(s):

Chiara Donfrancesco ◽

Simonetta Palleschi ◽

Luigi Palmieri ◽

Barbara Rossi ◽

Cinzia Lo Noce ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Cardiovascular Diseases ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Low Risk ◽

Risk Population ◽

All Cause Mortality

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Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

Frontiers in Pharmacology ◽

10.3389/fphar.2021.767982 ◽

2021 ◽

Vol 12 ◽

Author(s):

Manyun Tang ◽

Yidan Wang ◽

Mengjie Wang ◽

Rui Tong ◽

Tao Shi

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Diseases ◽

Overlap Syndrome ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Obstructive Sleep ◽

Increased Risk ◽

All Cause Mortality ◽

Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p < 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

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Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.4 ◽

2021 ◽

pp. 1-7

Author(s):

J.J. Aziz ◽

K.F. Reid ◽

J.A. Batsis ◽

R.A. Fielding

Keyword(s):

United States ◽

Older Adults ◽

Grip Strength ◽

Muscle Weakness ◽

Rural Areas ◽

Gait Speed ◽

The United States ◽

Cross Sectional ◽

Comorbidity Burden ◽

Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

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Effects of smoking habit change on all-cause mortality and cardiovascular diseases among patients with newly diagnosed diabetes in Korea

Scientific Reports ◽

10.1038/s41598-018-23729-0 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

Mi Hee Cho ◽

Kiheon Lee ◽

Sang Min Park ◽

Jooyoung Chang ◽

Seulggie Choi ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Smoking Habit ◽

Newly Diagnosed ◽

All Cause Mortality ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

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Association of Grip Strength with All-Cause Mortality and Cause-Specific Mortality: Analysis of the Korean Longitudinal Study of Ageing (2006–2016)

Korean Journal of Family Practice ◽

10.21215/kjfp.2019.9.5.438 ◽

2019 ◽

Vol 9 (5) ◽

pp. 438-447 ◽

Cited By ~ 1

Author(s):

Somi Kim ◽

Songhwa Choi ◽

Jungeun Yoo ◽

Jungkwon Lee

Keyword(s):

Longitudinal Study ◽

Grip Strength ◽

All Cause Mortality ◽

Specific Mortality ◽

Mortality Analysis

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High-sensitivity troponin I and all-cause mortality in patients with stable COPD: an analysis of the COSYCONET study

European Respiratory Journal ◽

10.1183/13993003.01314-2019 ◽

2019 ◽

Vol 55 (2) ◽

pp. 1901314 ◽

Cited By ~ 7

Author(s):

Benjamin Waschki ◽

Peter Alter ◽

Tanja Zeller ◽

Christina Magnussen ◽

Johannes T. Neumann ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Diseases ◽

Cardiovascular Risk Factors ◽

Troponin I ◽

High Sensitivity ◽

Airflow Limitation ◽

Reference Limit ◽

High Sensitivity Troponin ◽

All Cause Mortality

Chronic obstructive pulmonary disease (COPD) is a leading cause of death with a considerable part of the population dying from cardiovascular diseases. High-sensitivity troponin I (hs-TnI) might help to better identify COPD patients at high risk of mortality. We aimed to study the predictive value of hs-TnI for all-cause mortality beyond established COPD assessments, and after consideration of relevant cardiovascular risk factors and prevalent cardiovascular diseases, in a broad population with stable COPD.Circulating hs-TnI concentrations together with a wide range of respiratory and cardiovascular markers were evaluated in 2085 patients with stable COPD across all severity stages enrolled in the multicentre COSYCONET cohort study. The primary outcome was all-cause mortality over 3 years of follow-up.Hs-TnI was detectable in 2020 (96.9%) patients. The median hs-TnI concentration was 3.8 ng·L−1 (interquartile range 2.5–6.6 ng·L−1), with levels above the 99th percentile reference limit of 27 ng·L−1 observed in 1.8% of patients. In Cox regression analyses including adjustments for airflow limitation, dyspnoea grade, exercise capacity and history of severe exacerbations, as well as traditional cardiovascular risk factors, estimated glomerular filtration rate, ankle–brachial index, N-terminal pro-brain natriuretic peptides and prevalent cardiovascular diseases, hs-TnI was a significant predictor for all-cause mortality, both as a continuous variable (hazard ratio (HR) for log hs-TnI 1.28, 95% CI 1.01–1.62) and categorised according to the cut-off of 6 ng·L−1 (HR 1.63, 95% CI 1.10–2.42).In patients with stable COPD, hs-TnI is a strong predictor of all-cause mortality beyond established COPD mortality predictors, and independent of a broad range of cardiovascular risk factors and prevalent cardiovascular diseases. Hs-TnI concentrations well below the upper reference limit provide further prognostic value for all patients with COPD when added to established risk assessments.

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Magnesium, Oxidative Stress, Inflammation, and Cardiovascular Disease

Antioxidants ◽

10.3390/antiox9100907 ◽

2020 ◽

Vol 9 (10) ◽

pp. 907 ◽

Cited By ~ 1

Author(s):

Man Liu ◽

Samuel C. Dudley

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Heart Failure ◽

Cardiovascular Disease ◽

Clinical Trials ◽

Cardiovascular Diseases ◽

Serum Magnesium ◽

Mg Deficiency ◽

All Cause Mortality ◽

Low Serum

Hypomagnesemia is commonly observed in heart failure, diabetes mellitus, hypertension, and cardiovascular diseases. Low serum magnesium (Mg) is a predictor for cardiovascular and all-cause mortality and treating Mg deficiency may help prevent cardiovascular disease. In this review, we discuss the possible mechanisms by which Mg deficiency plays detrimental roles in cardiovascular diseases and review the results of clinical trials of Mg supplementation for heart failure, arrhythmias and other cardiovascular diseases.

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