Muscle Strength and Body Size and Later Cerebrovascular and Coronary Heart Disease
Bibliographic record
Abstract
OBJECTIVE: To investigate the associations between muscle strength, relative weight, and stature in young adulthood with later coronary heart disease (CHD) and stroke incidence. DESIGN: Cohort study. SETTING: Baseline data were drawn from the Swedish Military Service Conscription Register from the records of 1969 to 1994. PARTICIPANTS: At baseline, male Swedish citizens born between 1951 and 1976 (median age, 18.2 y) attended a mandatory conscription examination from which the only grounds for exemption were a severe handicap or a chronic disease. Full data sets with blood pressure in the acceptable range [diastolic (DBP), 40-100 mm Hg and systolic (SBP), 100-180 mm Hg] were available for 1 145 467 men (99%). ASSESSMENT OF RISK FACTORS: The conscription examination included measurements of elbow flexion, hand grip, and knee extension strength; DBP and SBP, and height and weight for calculation of body mass index (BMI). Data on education and socioeconomic status were derived from censuses conducted every decade. MAIN OUTCOME MEASURES: The main outcome measures were fatal and nonfatal CHD events and hemorrhagic and ischemic strokes in relation to strength, BMI, and height. Follow-up data were collected from 1969 to 2006 from the Swedish Cause of Death Register, Swedish Hospital Discharge Register, and Statistics Sweden's Emigration Register. Follow-up time was counted from conscription examination to death or hospitalization (median follow-up time, 24.4 y). Standardized hazard ratios (HR) were calculated for a 1-SD increase in the exposure variables. MAIN RESULTS: During the follow-up period 12 323 CHD and 8865 stroke cases occurred. After adjustment for other risk factors, strength indicators were inversely associated with CHD and all strokes (HR for CHD: elbow flexion strength, 0.95; 95% confidence interval [CI], 0.93-0.97; grip strength, 0.89; 95% CI, 0.88-0.91; knee extension strength, 0.92; 95% CI, 0.90-0.94; and HR for stroke: elbow flexion strength, 0.96; 95% CI, 0.94-0.99; grip strength, 0.95; 95% CI, 0.93-0.97; knee extension strength, 0.93; 95% CI, 0.90-0.95). Greater grip strength predicted a lower risk of intracerebral infarction (HR, 0.91; 95% CI, 0.88-0.95) and greater knee extension strength predicted a lower risk of intracerebral and subarachnoid hemorrhagic stroke (HR, 0.88; 95% CI, 0.82-0.93 and HR, 0.92, 95% CI, 0.86-0.99, respectively). Risk of CHD and intracerebral infarction increased progressively with increasing BMI, whereas both very low BMI and overweight were associated with intracerebral and subarachnoid hemorrhagic stroke. Tallness was positively associated with lower rates of CHD and stroke. CONCLUSIONS: Muscle strength was inversely associated with risk of fatal and nonfatal coronary heart disease and stroke, independently of associations of BMI and stature with mortality and morbidity, during 24 years of follow-up of men on Swedish conscription rolls.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".