Hypertension syndrome of pregnancy (HDP) is a leading cause of maternal mortality worldwide. Additionally, HDP can cause fetal growth restriction, premature birth, and a variety of adverse long-term health effects. Therefore, it is important to identify women at high risk and implement early interventions targeting modifiable risk factors. Grip strength is a leading indicator of muscle strength and overall health. Several prospective studies in the general population have shown that decreased grip strength is associated with increased cardiovascular disease and related mortality. However, the relationship between grip strength and HDP in pregnant women remains unclear. Furthermore, previous studies have reported inconsistent findings regarding absolute and relative grip strength (i.e., absolute grip strength standardized by body weight or BMI) in relation to health outcomes. Both absolute and relative measures need to be considered when understanding the relationship between grip strength and outcome.
To address this gap, Professor An Pan and Dr Yuxiang Wang investigated the association between absolute and relative grip strength during early pregnancy and subsequent risk of HDP. This study involved 6,802 pregnant women with an average age of 26.6 years from the Tongji, Huaxi, and Shuangli birth cohorts. During follow-up, 180 participants were diagnosed with HDP. Grip strength was measured in early pregnancy and assessed in three ways: absolute grip strength and two relative indices (absolute grip strength normalized to BMI or body weight). This study was published online on April 1, 2026. Chinese medical journal.
The results showed that there was an inverse relationship between grip strength and HDP risk. When participants were categorized into quartiles according to absolute grip strength, the odds ratios (95% confidence intervals) for HDP in the second to fourth quartile compared to the lowest quartile were 0.93 (0.63 to 1.35), 0.67 (0.44 to 1.00), and 0.35 (0.21 to 0.56), respectively. A similar trend was observed for relative grip strength. Restricted cubic spline analysis showed a nonlinear association between absolute grip strength and HDP risk. The risk was stable at low absolute grip strength levels, but decreased linearly after a certain threshold was reached. In contrast, both relative grip strength measurements showed linear correlations with HDP risk. Subgroup analyzes by age, parity, and physical activity level showed similar patterns and no significant interactions.
According to Professor Pan, these differences may be partially explained by the correlation between absolute grip strength and body weight. ”Absolute grip strength tends to be higher in people with higher body weight, but higher body weight itself is a risk factor for HDP.” he pointed out.Small increases in muscle strength may not be able to offset the negative effects of excess fat mass, which explains some of the nonlinear associations we observed.”
Professor Pan added that several biological mechanisms may link muscle strength and HDP. ”Handgrip training has been shown to reduce oxidative stress and inflammation, two important pathways in HDP development. Myokines released from muscle contraction, such as irisin, may also exert antihypertensive effects. Animal studies suggest that increased irisin levels may improve preeclampsia by promoting vascular remodeling and embryo implantation. Further cohort studies and clinical trials are needed to clarify whether improving grip strength helps reduce HDP risk.”
In conclusion, this cohort study comprehensively investigated the association between absolute and relative grip strength and HDP. In particular, the robust and linear association between relative grip strength and HDP across subgroups suggests its potential as a simple tool for risk stratification of HDP.
sauce:
Chinese Medical Journal Publishing Co., Ltd.
Reference magazines:
Wang, Y. others. (2026). Association between grip strength and pregnancy-induced hypertension: A prospective analysis in Tongji, Huaxi, and Shuangliu birth cohorts. Chinese medical journal. DOI: 10.1097/CM9.0000000000004024. https://journals.lww.com/cmj/fulltext/9900/association_between_grip_strength_and_hypertensive.2007.aspx
