Abstract
Muscle strength and body size may be associated with coronary heart disease (CHD) and stroke risk. However, perhaps because of a low number of cases, existing evidence is inconsistent. Height, weight, systolic (SBP) and diastolic blood pressure (DBP), elbow flexion, hand grip and knee extension strength were measured in young adulthood in 1 145 467 Swedish men born between 1951 and 1976. Information on own and parental social position was derived from censuses. During the register-based follow-up until the end of 2006, 12 323 CHD and 8865 stroke cases emerged, including 1431 intracerebral haemorrhage, 1316 subarachoid haemorrhage and 2944 intracerebral infarction cases. Hazard ratios (HR) per 1 SD in the exposures of interest were computed using Cox proportional hazard model. Body mass index (BMI, kg/m(2)) showed increased risk with CHD and intracerebral infarction, whereas for intracerebral and subarachoid haemorrhage both under- and overweight was associated with increased risk. Height was inversely associated with CHD and all types of stroke. After adjustment for height, BMI, SBP, DBP and social position, all strength indicators were inversely associated with disease risk. For CHD and intracerebral infarction, grip strength showed the strongest association (HR = 0.89 and 0.91, respectively) whereas for intracerebral and subarachoid haemorrhage, knee extension strength was the best predictor (HR = 0.88 and 0.92, respectively). Body size and muscle strength in young adulthood are important predictors of risk of CHD and stroke in later life. In addition to adiposity, underweight needs attention since it may predispose to cerebrovascular complications.
Highlights
Obesity is one of the most important modifiable risk factors for coronary heart disease (CHD),[1] and there is strong evidence that it is independently associated with increased risk of cerebrovascular diseases.[2]
Even when muscle strength is closely associated with muscle mass, a previous study found that grip strength was associated with incidence of cardiovascular diseases (CVD) in men even after arm muscle area and fat free mass were taken into account suggesting independent effect.[5]
When we analysed socioeconomic differences in height, BMI and strength indicators, we found that men with better education and higher occupational socioeconomic position (SEP) were taller and had slightly lower BMI than those with lower social position (Table 2)
Summary
Obesity is one of the most important modifiable risk factors for coronary heart disease (CHD),[1] and there is strong evidence that it is independently associated with increased risk of cerebrovascular diseases.[2] In addition to adipose mass, muscle mass may have important effect on risk of cardiovascular diseases (CVD). Perhaps because of a low number of cases, existing evidence is inconsistent
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