The strength of your handshake could signal the chance of a future heart attack, a major study in The Lancet suggests.

The research found the vigour of a person's hand-grip could predict the risk of heart attacks and strokes - and was a stronger predictor of death than checking systolic blood pressure.

Experts said a grip test could be a simple, low-cost way to predict the risk of heart attacks and strokes.

The international study, involving almost 140,000 adults in 17 countries found weak grip strength is linked with shorter survival and a greater risk of having a heart attack or stroke.

It also found that grip strength is a stronger predictor of death than systolic blood pressure.

The researchers suggest that it could be used as a quick, low-cost screening tool by doctors to identify high-risk patients among people who develop major illnesses such as heart failure and stroke.

Reduced muscular strength, which can be measured by grip strength, has been consistently linked with early death, disability, and illness. But there has been limited research on whether grip strength could be used to indicate heart health.

The new study followed 139,691 adults aged between 35 and 70 living in 17 countries from The Prospective Urban-Rural Epidemiology (PURE) study for an average of four years. Grip strength was assessed using a handgrip dynamometer.

It is measured as the force exerted when a subject squeezes an object as hard as possible with their hands.

The findings show that every five kilos 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; a 17 per cent higher risk of non-cardiovascular mortality; and more modest increases in the risk of having a heart attack (seven per cent) or a stroke (nine per cent).

Overall, grip strength was a stronger predictor of all-cause deaths, including deaths from heart disease, than systolic blood pressure, which is normally seen as a "robust causal factor" for death, the study showed.

The associations persisted even after taking into account differences in other factors that can affect mortality or heart disease such as age, education level, employment status, physical activity level, and tobacco and alcohol use.

A low grip strength was linked with higher death rates in people who suffer a heart attack or stroke and non-cardiovascular diseases, for example cancer, suggesting muscle strength can predict the risk of death in people who develop a major illness.

Lead author Dr Darryl Leong, of McMaster University in Canada, said: "Grip strength could be an easy and inexpensive test to assess an individual's risk of death and cardiovascular disease.

"Further research is needed to establish whether efforts to improve muscle strength are likely to reduce an individual's risk of death and cardiovascular disease."

Commenting on the findings, Professor Avan Aihie Sayer, of Southampton University, and Professor Thomas Kirkwood, of Newcastle University, discuss whether grip strength could be a new biomarker of ageing.