Do you have a nice firm handshake, or is it not quite what it used to be? Are you the one in your family to whom everyone passes bottles and jars that require opening, or are you the first one to hand over the pesky pickle jar to someone else? None of these things might seem like a big deal, but if your hand-grip strength is now weaker than you remember, it just might signify a much larger problem. According to new research, a drop in your ability to grip may be a predictor of future heart disease.

The study, which was conducted at the Population Health Research Institute at McMaster University in Ontario, Canada, found that decreasing hand-grip strength may indicate an elevated risk of having a heart attack or stroke as well as premature mortality.¹ Preidt, Robert. “Hand-Grip Strength May Provide Heart Health Clues.” WebMD. 13 May 2015. Accessed 17 May 2015. http://www.webmd.com/heart/news/20150513/hand-grip-strength-may-provide-clues-to-heart-health The subjects were nearly 140,000 men and women between the ages of 35 and 70 residing in 17 countries around the world. Each of them underwent physical examinations that included grip-strength testing, and they were tracked for four years, on average.

The data showed that for every 11-pound reduction a volunteer experienced in their grip strength, there was a corresponding 17 percent increase in their risk of death from a heart-related condition as well as a 17 percent increase in risk of death from other, non-heart-related causes. The findings also showed a reduction in grip strength to be associated with a nine percent higher stroke risk and a seven percent elevated heart attack risk. And overall, an 11-pound decrease in hand-grip strength was linked to a 16 percent raised chance of dying from any cause at all.

The scientists factored a number of other elements into the statistics that could potentially affect the subjects’ risk of developing coronary heart disease and having a heart attack or stroke. They controlled for the influences of age, smoking, alcohol use, education level, physical activity, and employment, and the results remained intact.

While the investigation was not designed to prove cause and effect, it did show a substantial association between declining grip strength and a greater likelihood of heart attack, stroke, and early mortality. In fact, the results were determined to be a more accurate indicator of cardiovascular disease-related death than systolic blood pressure, the top number in a blood pressure measurement. Systolic blood pressure is a standard method of testing used to assess heart disease risk because it often rises as we age due to stiffening of the arteries and growing plaque deposits.

But this research makes a persuasive case for the use of a hand-grip strength test during annual check-ups. It is an easy, inexpensive, and seemingly clear-cut way to obtain potentially important information on the heart. Keep in mind, though, it is important to establish a baseline while you are healthy. Once a baseline has been established, all follow-up figures would show whether grip strength is stable or starting to decrease. If a downward slide in grip strength is discovered, greater monitoring and preventive action can be taken to potentially ward off a heart attack or stroke.

How could the strength in your hand possibly provide clues to your heart health? The link is not so farfetched as it initially might seem. A 2011 study published in the Journal of Strength and Conditioning Research found that hand-grip strength is a good predictor of total-body muscular strength and endurance.² Trosclair, D; et al. “Hand-Grip Strength as a Predictor of Muscular Strength and Endurance.” Journal of Strength and Conditioning Research. March 2011. Accessed 18 May 2015. http://journals.lww.com/nsca-jscr/Abstract/2011/03001/Hand_Grip_Strength_as_a_Predictor_of_Muscular.156.aspx So in the case of the current research, it could be that when the muscles of your hand are losing gripping strength, it is due to an overall weakening of body muscles, including the heart. Then again, it could be related to reduced oxygen flow to those muscles and increased CO2 retention as a result of declining heart function. But more analysis is needed to determine the exact mechanism at play here. And we don’t know whether improving hand-grip or muscle strength by itself can help lessen the chance of developing cardiovascular disease.

What we do know, however, is that working out–along with eating a healthy diet and losing weight–will improve your fitness, and that is an important part of lowering your risk of heart disease, stroke, and heart attack. So whether you’ve noticed a little weakness setting into your hand grip lately or not, getting regular exercise and choosing nutritious meals should go a long way toward keeping your heart nice and strong.