Handgrip Strength Asymmetry as a Marker of Silent Cerebrovascular Disease in Adults with Hypertension
DOI:
https://doi.org/10.53350/pjmhs02026209.6Keywords:
handgrip strength; handgrip asymmetry; hypertension; silent cerebrovascular disease; cerebral small-vessel disease; magnetic resonance imagingAbstract
Background: Silent cerebrovascular disease (CVD) is common in adult hypertensive patients and can only be detected when cognitive impairment arises. Asymmetry of handgrip strength could be a measure of cerebral injury that reflects disruption of bilateral motor pathways.
Objective: To assess the association between handgrip strength asymmetry and magnetic resonance imaging evidence of silent cerebrovascular disease in hypertensive adults.
Methods: A cross-sectional study was conducted from October 2024 to October 2025 and 120 adults with hypertension at Department of Medicine, General Hospital, Lahore were recruited. Three trials of each handgrip strength were taken with a calibrated dynamometer. Asymmetry was considered as an inter-hand difference of ≥ 10%. Evaluation of the brain magnetic resonance imaging included white matter hyperintensities, lacunes, cerebral microbleeds, and enlarged perivascular spaces. Independent associations were identified using multivariable logistic regression.
Results: The study included 66 men and 54 women, with a mean age of 56.5 ± 7.8 years. Of the 48 participants (40.0%) had handgrip asymmetry and of the 56 (46.7%) had silent cerebrovascular disease. Asymmetry was associated with higher prevalence of disease than was symmetrical strength (60.4% vs 37.5%, p=0.014). The asymmetry group showed a higher prevalence of WMH, lacunes, multiple imaging abnormalities, and microbleeds. Asymmetry was independently associated with silent cerebrovascular disease after adjusting for age, sex, diabetes, duration of hypertension, systolic blood pressure, renal function and average grip strength (adjusted odds ratio 2.61; 95% confidence interval 1.14–5.98; p=0.023).
Conclusions: Silent cerebrovascular disease was independently associated with handgrips strength asymmetry and might be used for risk classification in adults with hypertension.
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Copyright (c) 2026 Farah Shafi, Iqra Kanwal, Naveed, Nazish Jamil, Arooj Tassadaq, Noor E Seher
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