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Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study

Timpka, Simon LU ; Petersson, Ingemar LU ; Zhou, Caddie LU and Englund, Martin LU (2014) In BMC Medicine 12(1).
Abstract
Background



Ischemic heart disease and stroke are two severe types of cardiovascular disease (CVD), a major contributor to the global burden of disease. The preventive framework currently includes promotion of both adequate cardiorespiratory and muscular fitness. Although muscle fitness is established as an indicator of health, it is currently unknown whether muscle strength is associated with later CVD independently of cardiorespiratory fitness.

Methods



We studied 38,588 Swedish men who in 1969 to 1970 (typically aged 18 years) completed compulsory conscription. Using the mean standardized score of three isometric muscle strength tests performed at conscription (hand grip, elbow flexion and... (More)
Background



Ischemic heart disease and stroke are two severe types of cardiovascular disease (CVD), a major contributor to the global burden of disease. The preventive framework currently includes promotion of both adequate cardiorespiratory and muscular fitness. Although muscle fitness is established as an indicator of health, it is currently unknown whether muscle strength is associated with later CVD independently of cardiorespiratory fitness.

Methods



We studied 38,588 Swedish men who in 1969 to 1970 (typically aged 18 years) completed compulsory conscription. Using the mean standardized score of three isometric muscle strength tests performed at conscription (hand grip, elbow flexion and knee extension), we categorized the subjects into three groups with the 25th to 75th percentile defining the reference category. We followed the cohort until 2012 for diagnosed CVD events and mortality via national health care registers and the national cause of death register. To estimate hazard ratios (HR) for CVD events (coronary heart disease or stroke) and CVD mortality we used Cox proportional hazard models adjusted for body mass index, smoking, alcohol consumption, cardiorespiratory fitness and socioeconomic status.

Results



Men with high muscle strength in adolescence had a decreased risk of later CVD events (HR 0.88, 95% confidence interval 0.77 to 0.99), whereas we observed no increased risk in men with low muscle strength (0.99, 0.86 to 1.13). However, low muscle strength was associated with increased risk of CVD mortality during middle age (1.31, 1.02 to 1.67).

Conclusions



Muscle strength in adolescent men is inversely associated with later CVD events and CVD mortality in middle age, independently of cardiorespiratory fitness and other important confounders. Thus, the role of muscle fitness in the prevention and pathogenesis of CVD warrants increased attention. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular disease, Coronary heart disease, Stroke, Muscle strength, Prevention, Epidemiology
in
BMC Medicine
volume
12
issue
1
publisher
BioMed Central
external identifiers
  • wos:000335255200001
  • scopus:84899946439
ISSN
1741-7015
DOI
10.1186/1741-7015-12-62
language
English
LU publication?
yes
id
e8bdb13c-f36d-448a-8c4e-89bc36c3b833 (old id 4438663)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/?term=24731728
date added to LUP
2014-05-19 12:04:07
date last changed
2017-10-01 04:20:35
@article{e8bdb13c-f36d-448a-8c4e-89bc36c3b833,
  abstract     = {Background<br/><br>
<br/><br>
Ischemic heart disease and stroke are two severe types of cardiovascular disease (CVD), a major contributor to the global burden of disease. The preventive framework currently includes promotion of both adequate cardiorespiratory and muscular fitness. Although muscle fitness is established as an indicator of health, it is currently unknown whether muscle strength is associated with later CVD independently of cardiorespiratory fitness.<br/><br>
Methods<br/><br>
<br/><br>
We studied 38,588 Swedish men who in 1969 to 1970 (typically aged 18 years) completed compulsory conscription. Using the mean standardized score of three isometric muscle strength tests performed at conscription (hand grip, elbow flexion and knee extension), we categorized the subjects into three groups with the 25th to 75th percentile defining the reference category. We followed the cohort until 2012 for diagnosed CVD events and mortality via national health care registers and the national cause of death register. To estimate hazard ratios (HR) for CVD events (coronary heart disease or stroke) and CVD mortality we used Cox proportional hazard models adjusted for body mass index, smoking, alcohol consumption, cardiorespiratory fitness and socioeconomic status.<br/><br>
Results<br/><br>
<br/><br>
Men with high muscle strength in adolescence had a decreased risk of later CVD events (HR 0.88, 95% confidence interval 0.77 to 0.99), whereas we observed no increased risk in men with low muscle strength (0.99, 0.86 to 1.13). However, low muscle strength was associated with increased risk of CVD mortality during middle age (1.31, 1.02 to 1.67).<br/><br>
Conclusions<br/><br>
<br/><br>
Muscle strength in adolescent men is inversely associated with later CVD events and CVD mortality in middle age, independently of cardiorespiratory fitness and other important confounders. Thus, the role of muscle fitness in the prevention and pathogenesis of CVD warrants increased attention.},
  articleno    = {62},
  author       = {Timpka, Simon and Petersson, Ingemar and Zhou, Caddie and Englund, Martin},
  issn         = {1741-7015},
  keyword      = {Cardiovascular disease,Coronary heart disease,Stroke,Muscle strength,Prevention,Epidemiology},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Medicine},
  title        = {Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study},
  url          = {http://dx.doi.org/10.1186/1741-7015-12-62},
  volume       = {12},
  year         = {2014},
}