TRIP

Muscle strength and body size and later cerebrovascular and coronary heart disease.

Clinical Journal of Sport Medicine, 2010

Comment on: OBJECTIVE: To investigate the associations between muscle strength, relative weight, and stature in young adulthood with later coronary heart disease (CHD) and stroke incidence.
SETTING: Baseline data were drawn from the Swedish Military Service Conscription Register from the records of 1969 to 1994.
PARTICIPANTS: At baseline, male Swedish citizens born between 1951 and 1976 (median age, 18.2 y) attended a mandatory conscription examination from which the only grounds for exemption were a severe handicap or a chronic disease.
Full data sets with blood pressure in the acceptable range [diastolic (DBP), 40-100 mm Hg and systolic (SBP), 100-180 mm Hg] were available for 1 145 467 men (99%).
ASSESSMENT OF RISK FACTORS: The conscription examination included measurements of elbow flexion, hand grip, and knee extension strength; DBP and SBP, and height and weight for calculation of body mass index (BMI).
MAIN OUTCOME MEASURES: The main outcome measures were fatal and nonfatal CHD events and hemorrhagic and ischemic strokes in relation to strength, BMI, and height.
Follow-up time was counted from conscription examination to death or hospitalization (median follow-up time, 24.4 y).
After adjustment for other risk factors, strength indicators were inversely associated with CHD and all strokes (HR for CHD: elbow flexion strength, 0.95; 95% confidence interval [CI], 0.93-0.97; grip strength, 0.89; 95% CI, 0.88-0.91; knee extension strength, 0.92; 95% CI, 0.90-0.94; and HR for stroke: elbow flexion strength, 0.96; 95% CI, 0.94-0.99; grip strength, 0.95; 95% CI, 0.93-0.97; knee extension strength, 0.93; 95% CI, 0.90-0.95).
Greater grip strength predicted a lower risk of intracerebral infarction (HR, 0.91; 95% CI, 0.88-0.95) and greater knee extension strength predicted a lower risk of intracerebral and subarachnoid hemorrhagic stroke (HR, 0.88; 95% CI, 0.82-0.93 and HR, 0.92, 95% CI, 0.86-0.99, respectively).
Risk of CHD and intracerebral infarction increased progressively with increasing BMI, whereas both very low BMI and overweight were associated with intracerebral and subarachnoid hemorrhagic stroke.