Grip Strength and Cardiovascular Health

By Koob Moua, OTR/L

Understand your heart health, predict heart disease, and improve your lifespan with three simple squeezes under 1 minute.

Turn on the news during the health education segment and nine times out of ten, you will hear a health expert going on and on about the importance of heart disease. What is the general solution? As most audiences are already aware, the solution is no surprise – exercise, a healthy diet, maintain a healthy blood pressure and lower salty foods. One solution that may surprise most people is just as effective as the four variables mentioned earlier to predict the severity of heart disease– grip strength.

Cardiovascular disease is jargon for heart and blood vessel disease in the healthcare world. Used often as an umbrella term, cardiovascular disease encompasses several different types of heart and blood vessel diseases: 

• Coronary heart disease: a disease of the blood vessels supplying the heart muscle. A buildup of plaque can narrow your arteries that decrease blood flow to the heart, with a complete blockage leading to a heart attack. 
• Cerebrovascular disease: a disease of the blood vessels supplying the brain. When blood vessels narrow, a clot forms, or arteries become blocked due to plaque buildup, the result is a stroke. On a rarer occasion, blood vessels can also rupture, causing a brain bleed. 
• Peripheral artery disease: a disease of blood vessels supplying the arms and legs. Common signs and symptoms include pain in the legs when walking that resolve with rest, aches or cramps with walking, loss of muscles in the legs, skin that is cool to the touch. When blood flow becomes really bad towards the legs or arms, amputations are often the last resort option to prevent further worsening of disease progression. 
• Deep vein thrombosis and pulmonary embolism: blood clots in the leg veins, which can dislodge and move to the heart and lungs. 

How can grip strength be tied to how healthy a person’s heart is? There are a couple of things to keep in mind as we continue to better understand how grip strength and heart disease are related: 

• Strength of relationship vs causality: Just to get the facts out, better grip strength does not directly cause or lead to a healthier heart. Rather, in the field of research, experts study the relationship between grip strength and cardiovascular disease to identify how closely associated both variables are with one another. For example, many experts have found that people with stronger grip strength tend to have lower risk or evidence of cardiovascular disease. Vice versa, people with low grip strength tend to have higher risk for existing cardiovascular disease. 
• Theories and mechanisms: Not satisfied with the reciprocal relationship between grip strength and cardiovascular health? Not a problem! Some posited theories and mechanisms further explain why grip strength actually may contribute to healthier heart function and structure:
• Grip strength and heart function: When looking at how well a heart is functioning, two fancy terms called ‘left ventricular end-diastolic volume’ and ‘left ventricular stroke volume’ are used to measure how much blood is distributed to the body from the heart. More formally, the left side of the heart receives oxygen rich blood from the lungs and then the left side of the heart contracts and squeezes oxygen rich blood to supply our bodies to function optimally. What experts have seen in their research is that people with strong grip strength tend to have a heart that squeezes more oxygen rich blood from their left side of their hearts to supply their bodies to complete their day to day activities or even during physically taxing activities. 
• Grip strength and walking distance: Aside from looking at heart function, when it comes to testing how well a person can actually do with a healthy heart, endurance testing is considered the crème de la crème assessment. A functional activity that is often seen in the world of rehabilitation is the distance a person can walk within a certain time limit. What do we end up seeing in those with stronger grip strength? Seniors with stronger grip strength walk a remarkably further distance when timed for 6 minutes compared to seniors with weaker grip strength. 

Grip Strength and Longevity with Heart Disease 

What is the science saying and what are the experts finding out about grip strength and its relationship with the heart? The first to address is longevity when already having some form of heart disease. Experts have found consistent and staggering results showing that when a person has better grip strength along with an already pre-existing heart condition, they have: 

• Better longevity (able to live longer years after having heart disease) 
• Less likelihood for disability 
• Short length of stay and faster recovery after surgery to fix the heart disease
• Better chances to prevent more heart diseases from occurring 

Determining what is considered good grip strength versus low grip strength can be a bit tricky. There isn’t a set number that is considered low vs high grip strength because a person’s hand size, body weight, and age can contribute to what a person’s hand strength should be. Although several variables contribute to what a normal grip strength should be for each individual person, what research has found is that: 

• Less than 57 pounds in men is on average considered low grip strength
• Less than 35 pounds in women is on average considered low grip strength 

Grip strength vs Other Forms of Measurement

Before we get too deep into the conversation, by no means should grip strength replace a healthy diet, exercise, or monitoring of blood pressure. Consider grip strength as an additive recipe to understand how to maintain a healthy heart, improve longevity after heart disease, and also prevent heart disease. Similar to keeping a blood pressure machine at home to regularly monitor vitals or keeping a scale to monitor one’s weight, grip strength can also be conveniently measured. 

Grip strength is measured by use of a device called a ‘dynamometer’ used commonly by occupational and physical therapists in clinical settings to determine a person’s grip strength. An affordable, convenient, and easy device that has gained popularity is known as the Handexer. How to use it? A few simple steps:

1. Insert batteries for the device to turn on. 
2. Position Handexer with digital scale facing upwards to allow for you to see. 
3. Place ‘testing hand’ with all four fingers on the blue grooves with the end of the dynamometer positioned at the palm area between your thumb and index finger. 
4. Set the scale either to ‘lbs’ or ‘kg’ for your own preference. 
5. Before squeezing, position the testing arm close to your trunk and arm at a ninety-degree position.
6. Squeeze as hard as you can for ~2-3 seconds and relax your grip. Record the number in ‘lbs’ or ‘kg’. Take a 15-30 second rest break. Squeeze the same testing hand for two more repetitions and take the average of the three numbers. 
7. The average of the three squeezes represents your grip strength!

Convenience of Grip Strength

Why the dynamometer? It’s quick, easy, and light. Because grip strength has the ability to predict the health of a person’s heart, prevent heart disease, and improve longevity after heart disease just as closely as blood pressure is, using a device such as the Handexer is less intimidating than using a blood pressure machine. Blood pressure changes throughout the day based on caffeine intake, timing of medications, stress, feelings of fatigue and other variables – making it much more difficult to determine the accuracy and interpretation of the results. In less than one minute and after three squeezes, you’re able to obtain similar predictability of your heart’s health! 

About the Handexer

As an occupational therapist, I cannot vouch enough for the convenience of a dynamometer that can fit in my lab coat to assess my patient’s hand strength. The hand strength allows me to make a good judgment with the patient’s progress, their duration in which they will be working with me, and most importantly, their overall longevity if battling heart disease. The Handexer can be purchased under $40 and be used for clinical purposes or for a person’s own monitoring of their own hand strength at home. 

About the Author

Koob Moua, OTR/L, has a doctoral degree in occupational therapy. He works in a physical medicine rehabilitation setting to help people return to their lives and families after experiencing severe physical trauma, disability, or a new medical diagnosis through rehabilitation. In his free time, he advocates for his profession by publishing academic journals focusing on self-management of chronic diseases, cooking, spending time with his two cats, and doing muay thai.