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.
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.
Mayo Clin Proc. 2021 Jun;96(6):1490-1499. doi: 10.1016/j.mayocp.2020.09.040. Epub 2021 Mar 26.
To evaluate the nature, magnitude, and specificity of the association between handgrip strength (HGS) and heart failure (HF) risk.
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.
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.
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.
评估握力(HGS)与心力衰竭(HF)风险之间关联的性质、程度和特异性。
1998 年 3 月 1 日至 2001 年 12 月 31 日,通过使用手持式测力计,在芬兰库奥皮奥缺血性心脏病前瞻性人群队列中对 770 名年龄在 61 至 74 岁、无 HF 病史的男性和女性进行了基线握力评估。相对 HGS 通过将绝对值除以体重获得。使用 Cox 回归模型估计风险比(HR)及其 95%置信区间。我们使用多重插补来处理缺失数据。
在中位数(四分位距)为 17.1(11.3-18.3)年的随访期间,记录了 177 例 HF 事件。握力与 HF 风险持续相关,呈曲线关系。在校正了几个已确立的风险因素和其他潜在混杂因素后,相对 HGS 每增加 1 SD,HF 的 HR(95%CI)为 0.73(0.59-0.91)。与相对 HGS 的最高和最低三分位数相比,相应的调整 HR 为 0.55(0.38-0.81)。在几个临床亚组中,这种关联仍然相似。插补结果与观察结果基本相似。
相对 HGS 与一般人群未来 HF 风险呈负相关且持续相关。需要进一步研究以评估 HGS 是否可作为一般人群 HF 的有用预后工具,以及阻力训练是否可降低 HF 风险。