A weak handshake could mean your health is in trouble, according to a new study.

Canadian researchers have linked poor hand grip strength to a greater risk of early death, stroke and heart attack.

The study, published in The Lancet, followed nearly 140,000 adults from 17 countries, including Canada. It found that grip strength is a “stronger predictor of death than systolic blood pressure.”

“We think it fits the measure of someone’s frailty, and frailty can be thought of as your ability to withstand having a disease,” said lead study author Dr. Darryl Leong.

Lack of muscle strength has long been associated with early death and illness. But data on the correlation between grip strength and major health problems has been limited until now.

For The Lancet study, researchers measured hand grip strength of adults living in 17 culturally and economically diverse countries. Those countries included Pakistan, Zimbabwe, Iran, China, Argentina and Sweden.

The study involved people between the ages of 35 and 70, who were followed over four years. They were asked to squeeze an object as hard as possible with their hands in order to measure the force exerted by their grip.

The study found that every five-kilogram decline in grip strength was associated with a 16 per cent increased risk of death from any cause, a 17 per cent greater risk of cardiovascular death, and a 17 per cent higher risk of non-cardiovascular death.

The risk of suffering a heart attack or a stroke increased by seven and nine per cent respectively.

Researchers say those increased risks persisted even after other factors were taken into consideration, such as age, physical activity, alcohol and tobacco use, as well as education level and employment.

Leong said grip strength can be used as an “easy and inexpensive test” to assess a patient’s risk of death and cardiovascular disease.

“We now have evidence of a simple and inexpensive tool that can be used to identify individuals at high risk of dying and individuals at high risk of succumbing to illness,” said Leong, a cardiologist and researcher at Hamilton Health Sciences and McMaster University in Hamilton, Ont. “And this is particularly important in lower income settings.”

Leong also said more research is needed to determine whether improving muscle strength reduces those risks.

Dr. Mary Nagai, a researcher at the Toronto Rehab Institute, said the findings have positive implications for a wide range of care.

“I think it is something that all of us could use in our offices, not just physicians,” Nagai told CTV News. “It can be used for physiotherapists or nurses, particularly nurses who do housecalls to people who can’t get out of their homes.”

With files from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip