Grip strength and walking pace and cardiovascular disease risk prediction in 406,834 UK Biobank participants

My grip strength was excellent with all the whitewater canoeing I was doing, my walking pace was also excellent.  The only way to know the stroke was going to occur was if my Dad's doctor had told him to get his kids tested when he was found to have 80% blockage in a carotid artery.  My risk level was non-existent from all the stroke risk calculators I have done. 

Buttercup whitewater slalom races in MN and WI, I took 1rst, 2nd and 3rd in the three years prior to stroke in OC1 and 1rst two years in a row in OC2(Open canoe 2 person), partners have those trophies. Have not paddled whitewater since, if I flipped I would not be able to swim myself, the canoe and the paddle to shore.  It is what I miss the most of my pre-stroke life.

 

Grip strength and walking pace and cardiovascular disease risk prediction in 406,834 UK Biobank participants

Mayo Clinic Proceedings — Welsh CE, Celis-Morales CA, Ho FK, et al. | April 14, 2020

This study was undertaken to evaluate whether the addition of grip strength and/or self-reported walking pace to established cardiovascular disease (CVD) risk scores improves their predictive abilities. Researchers included a sum of 406,834 participants from the UK Biobank, with baseline measurements between March 13, 2006, and October 1, 2010, without CVD at baseline. They evaluated the correlations of grip strength and walking pace with CVD outcomes using Cox models adjusting for classical risk factors (as included in established risk scores), and Via alterations in C-index and categorical net reclassification index, predictive utility was ascertained. The results of this study reveal that the addition of grip strength or usual walking pace to existing risk scores results in improved CVD risk prediction, with an additive impact when both are added. Although further external confirmation is needed, these tools could serve an important addition to CVD risk screening due to these measures are cheap and easy to administer.

• See Also: Implications of abnormal exercise electrocardiography with normal stress echocardiography

Read the full article on Mayo Clinic Proceedings

Increased walking pace reduces risk for CVD, mortality

How is your doctor making sure you can do this for all the benefits?  In fact your doctor should have a protocol to get you running again, not the tyranny of low expectations that you will be using a cane to hobble around with. Of course they cherry picked the participants by leaving out stroke patients.
https://www.healio.com/cardiology/chd-prevention/news/online/%7B407516e1-2e0f-46c1-bcf7-8c493e3c6cf1%7D/increased-walking-pace-reduces-risk-for-cvd-mortality?

Stamatakis E, et al. Br J Sports Med. 2018;doi:10.1136/bjsports-2017-098677.

June 20, 2018

Patients who increased their walking pace had reduced risk for CVD and all-cause mortality, according to a study published in the British Journal of Sports Medicine.

“Assuming our results reflect cause and effect, these analyses suggest that increasing walking pace may be a straightforward way for people to improve heart health and risk for premature mortality, providing a simple message for public health campaigns to promote,” Emmanuel Stamatakis, PhD, MSc, BSc, professor of physical activity, lifestyle and population health at University of Sydney, said in a press release. “Especially in situations when walking more isn’t possible due to time pressures or a less walking-friendly environment, walking faster may be a good option to get the heart rate up — one that most people can easily incorporate into their lives.”

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Researchers analyzed data from 50,225 patients from 11 pooled population British cohorts who reported at least one occasion of walking within the past 4 weeks and were free from angina, stroke, ischemic heart disease and prevalent cancer.

Surveys were completed between 1994 and 2008, which collected information on domestic physical activity, walking and participation in exercises and sports 4 weeks before the interview. Other data gathered included education, age, medical history, alcohol consumption and smoking status. Height and weight were measured and used to calculate BMI.

Among 49,731 patients who did not have an event during the first 24 months of follow-up, the risk for all-cause death was decreased in those who walked at an average (20%; 95% CI, 12-28) or brisk/fast pace (24%; 95% CI, 13-33) vs. those who walked at a slow pace. This was also seen in the risk for CVD mortality (24%; 95% CI, 9-36; 21%; 95% CI, 1-38, respectively).

There was clearer evidence of a link between walking pace and CVD and all-cause mortality in patients older than 50 years compared with other patients in the sample, although this was not seen for cancer mortality. Stronger evidence was also seen in patients who did not undertake vigorous-intensity activity and those who did not meet the physical activity recommendations.

Researchers saw no interactions by BMI or sex.

“Walking is a cornerstone of [physical activity] promotion for public health, but volume of walking (steps per day) has often been emphasized,” Stamatakis and colleagues wrote. “Given the perceived time barrier cited by those who fail to meet current [physical activity] guidelines, a pace change may be more feasible (for those with adequate physical capacity) than increased volume or duration.” – by Darlene

Large scale study shows slow walking pace is good predictor of heart-related deaths

What is your doctors protocol to get you walking at a brisk pace? I can do it but using the Trendelenburg gait and popping of the left knee.  That took years to accomplish and a few falls.  Hopefully those years of slow walking didn't leave me with a heightened risk of dying from heart problems. 

Large scale study shows slow walking pace is good predictor of heart-related deaths

29 August 2017 Leicester, University of

A team of researchers at the NIHR Leicester Biomedical Research Centre, UK - a partnership between Leicester’s Hospitals, the University of Leicester and Loughborough University - has concluded that middle-aged people who report that they are slow walkers could be at higher risk of heart disease compared to the general population.
The data analysed was collected between 2006 and 2010 by the UK Biobank from nearly half a million middle-aged people across the UK. 420,727 people were included in the research because they were free from cancer and heart disease at the time of collecting their information.
The study is published in the European Heart Journal.
In the following 6.3 years after the data was collected there were 8598 deaths with the sample population being studied: 1654 from cardiovascular disease and 4850 from cancer.
Professor Tom Yates, a Reader in Physical Activity, Sedentary Behaviour and Health at the University of Leicester and Principal Investigator for the study, said: “Our study was interested in the links between whether someone said they walked at a slow, steady or brisk pace and whether that could predict their risk of dying from heart disease or cancer in the future.
“Slow walkers were around twice as likely to have a heart-related death compared to brisk walkers. This finding was seen in both men and women and was not explained by related risk factors such as smoking, body mass index, diet or how much television the participants in the sample watched. This suggests habitual walking pace is an independent predictor of heart-related death.
“We also found that self-reported walking pace was strongly linked to an individual’s objectively measured exercise tolerance, further suggesting walking pace is a good measure of overall physical fitness. Therefore, self-reported walking pace could be used to identify individuals who have low physical fitness and high mortality risk that would benefit from targeted physical exercise interventions.”
The research team also analysed actual handgrip strength as measured by a dynamometer to see if it was a good predictor of cancer or heart-related deaths. Handgrip strength appeared to be only a weak predictor of heart-related deaths in men and could not be generalised across the population as a whole.
Associations between self-reported walking pace and handgrip strength and cancer-related deaths were not consistent.
The paper, ‘Association of walking pace and handgrip strength with all-cause, cardiovascular, and cancer mortality: a UK Biobank observational study’ was published on 21 August 2017 in the European Heart Journal.