What can your grip strength tell you about your heart? 

SPEAKER_1 (0:01)

Best of Live Well ft. Lance Alexander.

Lance Alexander (0:05)

Good morning Singapore. Now could something as simple as your grip strength offer clues about how well your heart is aging even when you feel healthy? Findings from the National Heart Centre Singapore's Cardiac Ageing Study suggest there is a connection. In older adults without known cardiovascular disease, weaker grip strength and lower muscle mass were associated with early changes in heart function. The findings build on research into Cardiosacropenia, the relationship between age-related changes in our muscles and heart.

They suggest the two may age together and raise the possibility that a simple hand grip test could eventually help flag early heart changes. Joining us is the study senior author, Associate Professor Angela Koh, Director Cardiovascular Ageing and Longevity Program at the National Heart Centre Singapore. Prof, good morning to you.

Angela Koh (1:06)

Good morning, Lance, and good morning, everyone.

Lance Alexander (1:09)

Thanks for coming in. So tell us, why is grip strength such a powerful clue to our heart health?

Angela Koh (1:16)

Thank you for the opportunity to share this work.

First of all, I think the study was performed around about six years ago, and we've been very fortunate to look at two very important organ systems that is of concern in aging populations. The first organ being the heart, obviously, exquisitely important because it pumps blood to the rest of the body and contributes to heart conditions. But the other very important organ that we studied was the skeletal muscle system. Now, back then, at that point in time when muscle health was less of a topic, we really wanted to find out if among patients or among our community older adults who haven't had yet cardiovascular disease, is there a way to understand it earlier with a view to getting a stronger handle on how we can actually prevent heart disease. And that was how it started.

Lance Alexander (2:25)

Could you tell us who took part in the study as well?

Angela Koh (2:28)

Yes, this is an entirely Singapore local resident study population, which makes it so relevant to a lot of us right now. This being an ageing and healthy longevity national priority, we are very grateful to all of them who came forward. They came to us, they did a whole series of cardiovascular assessments, as well as measurements of their heart muscle function. Importantly, what they also gave us was very detailed skeletal muscle function in terms of hand grip. I would like to also point to the fact that we had a very equal distribution of both men and women.

And this is very important because we do want to address both genders in terms of their aging trajectories with time. And we had a mean age of 71 years, which is really important because as we talk about living with healthier bodies, healthier health span, the 70 to 80 period is really a critical time period where certain risks accumulate and conditions accrue. And therefore, this was a really important critical window that we could study them.

Lance Alexander (3:49)

And I heard that over 250 people took part and they did not have pre-existing medical conditions, correct?

Angela Koh (3:57)

That's correct.

Lance Alexander (3:57)

Okay. So maybe now you can tell us about the study and how grip strength, muscle mass and the aging heart all play a part. How exactly?

Angela Koh (4:06)

Yep. So what we found was that when we looked at the heart, we looked very deeply into a particular function in the aging heart of concern. And that would be changes in the cardiovascular chamber. So the heart chambers of the heart. We did a very deep dive into understanding how the left atrium, which is the upper chamber, as well as the lower chamber, known as the left ventricle, were really talking to each other. And that refers to how much blood was transferred from the top chamber to the bottom chamber. And this is very important because we wanted to address the ongoing risk associated with aging heart. Conditions such as irregular heart rhythms, conditions such as heart failure, with preserved ejection fraction, and these two chambers and the way they coordinate with each other was really important.

We call this coupling, but really it is how the blood is transferred from the smaller chamber into the larger chamber. I'll just call that coupling. And interestingly, as we looked at the competency of this coupling among these older adults, we found that patients, participants who had poorer grip had actually poorer coupling.

The quantitative marker that was very useful was, we really could quantify that grip in kg. So, just to give some numbers, among those who had poorer coupling, their hand grip strength was mean of 22.8, whereas those with better or preserved coupling, the hand grip strength was 26.1.