Table 2.

Improvement in risk discrimination for all cause mortality and cardiovascular disease outcomes by addition of handgrip strength to model with conventional office based risk factors

	C index (95% CI)	C index change (95% CI)	P value
All cause mortality
Derivation cohort:
Conventional office based risk factors	0.722 (0.717 to 0.727)	0.013 (0.011 to 0.015)	<0.001
Plus handgrip strength	0.735 (0.730 to 0.740)
Validation cohort:
Conventional office based risk factors	0.722 (0.717 to 0.728)	0.012 (0.011 to 0.014)	<0.001
Plus handgrip strength	0.734 (0.729 to 0.740)
Cardiovascular disease mortality
Derivation cohort:
Conventional office based risk factors	0.788 (0.774 to 0.801)	0.012 (0.007 to 0.017)	<0.001
Plus handgrip strength	0.800 (0.786 to 0.913)
Validation cohort:
Conventional office based risk factors	0.787 (0.773 to 0.800)	0.011 (0.005 to 0.017)	<0.001
Plus handgrip strength	0.799 (0.785 to 0.812)
Cardiovascular disease incidence
Derivation cohort:
Conventional office based risk factors	0.736 (0.730 to 0.743)	0.009 (0.007 to 0.010)	<0.001
Plus handgrip strength	0.745 (0.739 to 0.751)
Validation cohort:
Conventional office based risk factors	0.737 (0.730 to 0.743)	0.009 (0.007 to 0.011)	<0.001
Plus handgrip strength	0.746 (0.740 to 0.751)

Data presented as C index and 95% CI and as differences in C index versus reference model. Reference model includes information on age, sex, body mass index (5 units), systolic blood pressure (10 mm Hg), history of diabetes, and smoking. Handgrip strength was added into model as 5 kg decrease in grip strength. Analyses were performed in derivation cohort and then in randomly selected internal validation cohort (~50% of cohort balanced by sex). Then Harrell’s C statistic was calculated in both derivation cohort (n=219 087) and validation cohort (n=218 852).