A trial on nearly 140,000 people in 14 countries, published in the Lancet, suggests grip strength is better than blood pressure at predicting risk.
The international research team said it would be a "simple, inexpensive" tool for doctors.
Experts argued the link between grip and the heart was unclear and needed more study.
The maximum crushing force you can exert in your grip naturally declines with age.
But those whose grip strength declines fastest may be at greater risk of health problems, the study suggests.
The huge trial, in 14 countries, showed each 11lb (5kg) reduction in grip strength increased the odds of an early death by 16%.
The odds of a fatal heart problem increased by 17% and a stroke by 9%.
Doctors currently calculate the chances of a heart attack or stroke by filling in a questionnaire with the patient by assessing age, whether they smoke, obesity, cholesterol levels, blood pressure where they live and family history.
The researchers argue grip strength makes more accurate predictions than blood pressure alone and could be a new tool for assessing risk.
Dr Darryl Leong, one of the researchers at 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."
It is still unknown why worsening heart health could manifest as a weaker grip.
Suggestions included hardening arteries reducing muscle strength.
Doireann Maddock, from the British Heart Foundation, said: "The findings of this study are interesting. However, it doesn't explain why grip strength should be related to cardiovascular disease.
"More research is needed to understand any possible link between the two.
"The good news is we already know there are several established risk factors for cardiovascular disease and an NHS health check can assess your risk."
The chances of having a heart attack, stroke or dying young may be hidden in the palm of the hand, a study suggests.