Grip strength predicts death risk better than blood pressure, global study finds

Handgrip strength predicted a person’s risk of death more reliably than blood pressure readings did, in a global study that tracked nearly 140,000 adults across 17 countries. Researchers measured grip strength with a handheld dynamometer in participants aged 35 to 70 living in both wealthy and low-income countries, and followed them for a median of four years. For every 5-kilogram decline in grip strength, the risk of death from any cause rose 16 percent, and the risk of cardiovascular death rose 17 percent.

The research came out of the Prospective Urban Rural Epidemiology study, known as PURE, a long-running project that recruited participants across high-, middle- and low-income countries specifically to test whether findings from wealthy nations hold up in poorer ones. Grip strength was already used by physical therapists to track frailty in older adults, but the PURE investigators wanted to know whether it said anything about a person’s broader risk of dying, independent of age, smoking status, physical activity, diet, alcohol use or income.

A Stronger Signal Than Blood Pressure

Grip strength turned out to be a stronger predictor of death than systolic blood pressure, according to the study results, published in The Lancet and led by Darryl Leong of the Population Health Research Institute at McMaster University and Hamilton Health Sciences. “Grip strength could be an easy and inexpensive test to assess an individual’s risk of death and cardiovascular disease,” Leong said, according to a release distributed by EurekAlert.

The relationship held regardless of income level, education, employment status, physical activity, diet, tobacco or alcohol use, according to a summary published by the Population Health Research Institute, the McMaster-affiliated institute that ran the study. A 5-kilogram drop in grip strength also corresponded to a 7 percent higher risk of heart attack and a 9 percent higher risk of stroke, on top of the overall mortality figures.

The size of the association surprised even the investigators: a 16 percent jump in all-cause mortality risk per 5 kilograms lost is comparable in scale to well-established risk factors doctors already screen for routinely. Non-cardiovascular deaths rose by roughly the same 17 percent per 5-kilogram decline as cardiovascular deaths did, the researchers found, suggesting grip strength was picking up on something broader than heart-specific risk alone.

The institute noted that individual results were also influenced by a participant’s overall body size and weight, and it said follow-up work was planned to examine whether the pattern held consistently across different ethnic groups, and whether deliberately building muscle strength through training could lower a person’s risk rather than simply reflect it.

A Simple Measurement With Outsized Value

Part of the appeal is logistical. Measuring grip strength takes a minute with a handheld dynamometer, requires no lab work, no imaging and no blood draw, and can be repeated at every visit to track change over time the way a nurse already tracks blood pressure or weight. That simplicity is what let PURE researchers collect data on nearly 140,000 people across 17 countries with vastly different levels of health infrastructure, from Canada and Sweden to India, China, Colombia and Zimbabwe, without needing a hospital lab on hand at every study site.

Later research has continued to support grip strength as a mortality signal. A 2024 analysis of federal health survey data covering 9,583 American adults, published in Scientific Reports, found that each 5-kilogram decline in grip strength raised mortality risk by 36 percent in men and 49 percent in women over roughly seven years of follow-up, and that raw handgrip strength predicted death about as well as more complicated formulas that adjusted for body size.

Researchers from the University of Southampton, commenting on the PURE results in a write-up by the medical news service Healio, suggested grip strength might be “a particularly good marker of underlying aging processes” rather than a reflection of muscle strength alone.

An Open Question About Building Strength

Leong’s team was careful to note that PURE was observational: it showed a correlation between weaker grip and higher mortality, not proof that strengthening a person’s grip would extend life. “Further research is needed to establish whether efforts to improve muscle strength are likely to reduce an individual’s risk,” Leong said, according to the EurekAlert release. More than a decade after publication, that specific question, whether a resistance-training program that raises grip strength also lowers a person’s mortality risk, remains open, even as grip testing has spread into geriatric clinics and frailty assessments as a quick screening tool.

For now, the practical advice drawn from PURE is modest: a simple squeeze test, taking seconds in a clinic, flags a risk that a stethoscope and a blood pressure cuff can miss, even if it does not yet tell doctors exactly how to fix it, or which patients would benefit most from trying.

This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.

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