Circulation, Vol 88, 1437-1443, Copyright © 1993 by American Heart Association
PR Hebert, JW Rich-Edwards, JE Manson, PM Ridker, NR Cook, GT O'Connor, JE Buring and CH Hennekens
BACKGROUND. An inverse association between height and risk of coronary
heart disease (CHD) has been reported in several case-control and cohort
studies, but the reasons for the association remain uncertain. We evaluated
this association among 22,071 male physicians, a population homogeneous for
high educational attainment and socioeconomic status in adulthood. METHODS
AND RESULTS. The study population was comprised of participants in the
Physicians' Health Study, a randomized, double-blind, placebo-controlled
trial of low-dose aspirin and beta-carotene in the primary prevention of
cardiovascular disease and cancer among US male physicians, aged 40 to 84
years, in 1982. Participants were classified into five height categories at
study entry, from shortest to tallest, and were followed an average of 60.2
months to determine the incidence of myocardial infarction (MI), stroke,
and death from cardiovascular disease. Men in the tallest (> or = 73 in.
or 185.4 cm) compared with the shortest (< or = 67 in. or 170.2 cm)
height category had a 35% lower risk of MI (relative risk, 0.65; 95%
confidence interval, 0.44 to 0.99; P = .04), after adjusting for known
cardiovascular risk factors. Further, a marginally significant inverse
trend (P trend = .05) across the height categories was observed. Although
the relationship was not strictly linear, for every inch of added height,
there was an approximate 2% to 3% decline in risk of MI. In contrast, men
in the tallest compared with the shortest height category had only small
and nonsignificant decreases in risk of stroke and cardiovascular death.
While no significant trend in risks of these end points across the height
categories was observed, the numbers of events for these end points were
far less than for MI, and thus the confidence intervals were wide.
CONCLUSIONS. These data indicate that height is inversely associated with
subsequent risk of MI. At this time, a few mechanisms are plausible, but
none are convincing. Other epidemiological and basic research efforts are
needed to explore a variety of physiological correlates of height that may
be responsible for mediating the height-MI association. In the meantime,
while height is not modifiable, it is easy to measure and may be useful to
evaluate CHD disease risk profiles and target lifestyle interventions.
ARTICLES
Height and incidence of cardiovascular disease in male physicians
Department of Medicine, Harvard Medical School, Boston, MA.
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