{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:03:01Z","timestamp":1785250981183,"version":"3.55.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"\n Background<\/jats:title>\n \n Grip strength and walking pace are potential indicators of adverse health outcomes for the general population. However, their role in primary cardiovascular disease (\n CVD)<\/jats:styled-content>\n prevention among various subpopulations remains uncertain.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 206\u2009371 individuals without\n CVD<\/jats:styled-content>\n (aged 40\u201369\u2009years) from\n the UK Biobank<\/jats:styled-content>\n were included. Four conventional\n CVD<\/jats:styled-content>\n prediction models (Framingham, Reynolds, ASSessing cardiovascular risk using Scottish Intercollegiate Guidelines Network [\n ASSIGN]<\/jats:styled-content>\n , and\n pooled cohort equations [PCEs]<\/jats:styled-content>\n ) were used to estimate 10\u2010year\n CVD<\/jats:styled-content>\n risk. Model performances were compared across diverse subpopulations defined by age, grip strength, or walking pace using a C index and calibration plot in\n the UK Biobank<\/jats:styled-content>\n . Added predictive value was further validated in\n ELSA (English Longitudinal Study of Ageing)<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During the follow\u2010up period 19\u2009664 cases of incident\n CVD<\/jats:styled-content>\n were registered (mean 12.85\u2009years [\n SD<\/jats:styled-content>\n 2.74]). Vulnerable subpopulations were characterized by advanced age, low grip strength, or slow walking pace. The\n ASSIGN<\/jats:styled-content>\n model showed lower C indexes in vulnerable subpopulations: 0.659 (95%\n CI<\/jats:styled-content>\n , 0.646\u20130.672) for low grip strength versus 0.702 (95%\n CI<\/jats:styled-content>\n , 0.699\u20130.706) for normal grip strength, 0.646 (95%\n CI<\/jats:styled-content>\n , 0.635\u20130.657) for slow walking pace versus 0.701 (95%\n CI<\/jats:styled-content>\n , 0.698\u20130.705) for normal walking pace, and 0.624 (95%\n CI<\/jats:styled-content>\n , 0.614\u20130.634) for older versus 0.701 (95%\n CI<\/jats:styled-content>\n , 0.689\u20130.712) for young subpopulation. Adding walking pace to the\n ASSIGN<\/jats:styled-content>\n model improved its discriminative ability in the older subpopulation with low grip strength (C index change, 0.027 [95%\n CI<\/jats:styled-content>\n , 0.009\u20130.045]). The finding was similar in\n ELSA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Walking pace, but not grip strength, improved the performance of conventional\n CVD<\/jats:styled-content>\n prediction models among vulnerable subpopulations. This highlights the role of physical function in primary prevention of\n CVD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.125.042337","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:52:39Z","timestamp":1777369959000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Walking Pace Optimizes Conventional Cardiovascular Disease Risk Prediction Models Among Vulnerable Subpopulations: A Prospective Cohort Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3495-6786","authenticated-orcid":false,"given":"Li","family":"Wang","sequence":"first","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]},{"name":"Zhejiang Chinese Medical University","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqin","family":"Li","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]},{"name":"Fudan University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqing","family":"Jia","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-5771","authenticated-orcid":false,"given":"Jing","family":"Shao","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.11.007"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.699579"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.6.611"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.108167"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2023.117217"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.24683"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-021-00486-z"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16329"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03527-4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064071"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac311"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","unstructured":"Celis\u2010Morales CA Welsh P Lyall DM Steell L Petermann F Anderson J Iliodromiti S Sillars A Graham N Mackay DF et\u00a0al. 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