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Short stature and heart disease: nature or nurture? The EARS Group
1Department of Epidemiology, Queen's University of Belfast, Royal Victoria Hospital, Northern Ireland.
Background:
Previous studies have demonstrated that short men are at increased risk of coronary heart disease (CHD). It has been suggested that the inverse relationship between adult height and CHD risk could be attributable to the fetal origins of CHD.
Method:
The hypothesis that transmissible factors could partly explain the association has been tested in the European Atherosclerosis Research Studies (I and II), in which a sample of healthy university students (cases), drawn from 18 European countries (male: n = 721; female: n = 330), whose fathers had had a documented myocardial infarction before the age of 55 years were compared to age- and sex-matched controls (male: n = 1056; female: n = 638). Information about lifestyle and birthweight was collected and a fasting blood sample was obtained from each subject.
Results:
In females there was no difference in height between cases and controls but male cases were shorter than controls, on average by one cm, both in the EARS I (P = 0.02) and the EARS II studies (P = 0.01) and this difference was independent of reported birthweight and the fathers' educational attainment. In logistic regression the relationship was independent of the subjects' apolipoprotein B level, the other major biological discriminator of case-control status.
Conclusion:
In men at least, height appears to be an independent transmissible risk factor for CHD.