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Short stature linked to increased CHD risk

Eur Heart J 2010; Advance online publication

Short stature is associated with an increased risk for coronary heart disease (CHD), a Finnish study shows.


Reporting their findings in the European Heart Journal, Tuula Paajanen (Tampere University, Finland) and team comment that "short people have coronary arteries of smaller diameter which may be occluded earlier in life under conditions which amplify CHD risk." This may at least in part explain the increased risk for CHD in short individuals, they say.

Paajanen et al searched medical literature and identified 52 studies (3,012,747 patients) in which healthy individuals or symptomatic CHD patients of either gender were observed for the presence or development of CHD, myocardial infarction (MI), all-cause mortality, and cardiovascular disease (CVD) mortality. All the studies had a follow-up period of 2 or more years and had height information available as either a continuous or categorical variable. Based on this height information, the participants were allocated to a short (<160.5 cm) or tall (>173.9 cm) group.

The findings revealed that individuals of short stature were 55% more likely to die from CVD, and 49% more likely to develop or die from CHD, with their relative risk for all CVD endpoints combined increased by an average of 46%.

Further analysis of the effect of gender showed that the association between short stature and CHD morbidity and mortality existed in men. Risk for death and morbidity from CHD was 49% greater in short men (below 166.1 cm) compared with tall men (above 176.2 cm). The same association could not be confirmed for women due to insufficient data.

The researchers comment that variations in height classification among the different studies and genders prevent identification of the exact height at which CHD risk increases. Nevertheless, the consistency in findings despite this variation supports the existence of an association, a point agreed on in a related editorial by Jaakko Tuomilehto (University of Helsinki), who commented: "This meta-analysis provides solid proof for this."

Considering the ambiguity of body mass index values currently used to quantify risk for CHD, Paajanen et al conclude that "height may be considered as a possible independent factor to be used in CHD risk calculations."

Indeed, Tuomilehto suggested, there may be considerable benefits in using height as a method of risk identification from a very young age. He wrote: "Full term babies who are born small are likely to be short as adults. They should receive preventive attention early on."

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