title: Physical Health Indicators Improve Prediction of Cardiovascular and All-cause Mortality among Middle-Aged and Older People: a National Population-based Study.
abstract: The effectiveness of established methods for stratifying cardiovascular risk, for example, the Framingham risk score (FRS), may be improved by adding extra variables. This study evaluated the potential benefits of adding physical health indicators (handgrip strength, walking speed, and peak expiratory flow) to the FRS in predicting cardiovascular and all-cause mortality by using a nationwide population-based cohort study data. During median follow-up of 4.1 years, 67 of 911 study subjects had died. In Cox regression analysis, all additional physical health indicators, except walking speed, significantly predicted cardiovascular and all-cause mortality (P < 0.05). Compared with the conventional FRS, c statistics were significantly increased when dominant handgrip strength or relative handgrip strength (handgrip strength adjusted for body mass index), or combination with walking speed or peak expiratory flow were incorporated into the FRS prediction model, both in the whole cohort and also in participants who did not have prevalent cardiovascular diseases at baseline. In conclusion, dominant or relative handgrip strength are simple and inexpensive physical health indicators that substantially improve the accuracy of the FRS in predicting cardiovascular and all-cause mortality among middle-aged and older people.
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.|Institute of Public Health, National Yang Ming University, Taipei, Taiwan.|Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Taipei, Taiwan.
authors.forename: Wei-Ju
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.|Institute of Public Health, National Yang Ming University, Taipei, Taiwan.|Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Li-Ning
authors.initials: LN
authors.lastname: Peng
authors.affiliation: Institute of Public Health, National Yang Ming University, Taipei, Taiwan.|Health Promotion Administration, Ministry of Health and Welfare, R.O.C., Taiwan.
authors.forename: Shu-Ti
authors.initials: ST
authors.lastname: Chiou
authors.affiliation: Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.|Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D013624:Taiwan / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein