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definitely leads to increased risk of death among those with established CVD. In that context, the comment in an accompanying editorial by Sayer and Kirkwood is noteworthy; one way that reduced skeletal muscle strength increases incident CVD and its fatality, may be through it being a biomarker of the ageing process across the life course. Put simply, reduced grip strength might be a marker (or does it participate in the process too?) for vascular ageing in those with lower chronological age. This fits in well with the exploratory analysis by the authors showing its superiority as a risk factor over blood pressure and physical activity for CVD. This has important implications for South Asians who tend to have lower grip strength. Only 10% women and 5% men of South Asian ethnicity were represented in the tertile group with highest grip strength. While grip strength had a robust association with noncardiovascular mortality, surprisingly it did not correlate strongly with incident non-CVD, even falls and fractures which might be expected to increase with lower muscle strength. This could be due to upper limb strength not being a surrogate for lower limb strength that is required to prevent falls and the contribution of other factors such as balance. Even simpler could be the explanation that falls and injuries are not ascertained with same rigour in observational studies as the hard end-points such as mortality, MI and stroke. That it increased case-fatality rates for these conditions, once again directs us to the intriguing hypothesis that reduced muscle strength means, or causes (one does not know which at this point) an accelerated ageing process. Future work will undoubtedly put one of the spotlights on benchside for elucidating the pathways that connect grip strength with mortality and CVD. But it is the prospect of clinical trials investigating the impact of increasing grip strength on mortality and CVD, which is going to provide insightful times ahead for the clinician.