Body height is associated with decreased long-term stroke but not coronary heart disease mortality?

There is disagreement whether shorter persons suffer increased rates of coronary heart disease (CHD) or stroke. Potential mechanisms for such associations are not well understood. We used findings from a cohort study, in which 10 000 Israeli men were followed up, to examine the associations between stature and fatal CHD as well as fatal stroke.

The cohort was composed of 10 059 men aged > or = 40 years who were tenured civil servants or municipal employees. They were followed up for mortality over 23 years (1963 to 1986), for a total of 203 452 person-years of follow-up. We divided men by their height, as measured in the baseline (1963) examinations, into quartiles (< or = 162 cm, 163 to 167 cm, 168 to 171 cm, and > or = 172 cm).

During the follow-up period, 1098 men died of CHD, and 364 men died of stroke. Height and weight had been measured for 10 034 men, including all but 1 of the deceased. In contrast to the finding of little variation of CHD death rates between different quartiles of body height, a clear significant pattern of declining stroke mortality (slightly reduced by age adjustment) was observed with increasing body height, with rates of 46, 36, 33, and 29 per 1000 men with increasing height quartiles, respectively (P=0.002 for linear trend). The estimated age-adjusted hazard risk of stroke mortality associated with a 5-cm decrement in height was 1.13 (95% CI 1.04 to 1.22). The respective risk associated with being at the shortest quartile versus the tallest one was 1.54 (95% CI 1.13 to 2.10). Adjustment for socioeconomic status, a predictor of stroke in this cohort, for antihypertensive therapy and for established predictors of stroke (blood pressure, smoking, and diabetes) did not alter these findings.

Height, a potential strong indicator of nutritional status, may be inversely associated with the long-term incidence of fatal stroke in a way that remains to be elucidated.