Adult height linked to the prevalence of coronary artery calcium
Adult height has been hypothesized to be inversely associated with coronary heart disease but studies have produced conflicting results.
In this new study Dr. Michael Miedema, MD, research cardiologist, Minneapolis Heart Institute Foundation and colleagues examined the association between adult height and the prevalence of coronary artery calcium (CAC), a direct measure of subclinical atherosclerosis and surrogate marker of CHD.
Coronary artery calcium (CAC) a direct marker of plaque in the arteries that feed the heart. Coronary artery calcium is a strong predictor of future heart attacks with a nearly 10 fold increase in the risk of coronary heart disease (CHD) in patients with elevated CAC.
Researchers examined this relationship in 2,703 participants from the NHLBI Family Heart Study (a multicenter, genetic-epidemiologic family study of the genetic/non-genetic and familial/non-familial causes and risk factors of coronary heart disease) who underwent cardiac computed tomography. The median age of participants was 54.8 years and 60.2% were female.
There was an inverse association between adult height and CAC.
After adjusting for age, race, field center, waist circumference, smoking, alcohol, physical activity, systolic blood pressure, anti-hypertensive medications, diabetes, diabetic medications, LDL cholesterol, HDL cholesterol, lipid-lowering medications, and income, researchers found that participants in the tallest quartile had 30% lower odds of having prevalent CAC.
There was no evidence of effect modification for the relationship between adult height and CAC by age or socioeconomic status.
This study suggests that taller adults appear to have lower levels of plaque which results in a lower risk for coronary heart disease.
In their conclusion the researchers writes “The results of our study suggest an inverse, independent association between adult height and CAC.”
In a press release Dr. Miedema comments “The results of our study suggest an inverse, independent association between adult height and CAC.” “There may be as much as 30% lower risk of plaque build-up in the top quarter of tallest adults compared to the bottom quarter. These results had to be adjusted for gender, given the differences in height between men and women, but the relationship was consistent in both men and women."
Why taller adults have developed less coronary artery calcium is not clear.
According to Dr. Miedema “Some studies suggest that taller people have favorable changes in their blood pressure due their height but these changes are quite small and unlikely to be the sole cause of this relationship.” “It may be more likely that this relationship is mediated through a common link, such as childhood nutrition or other environmental factors during childhood, which may be determinants of both adult height as well as future coronary heart disease."
This is the first study to examine the association between adult height and coronary artery calcium in a large population.
This study appears in Circulation: Cardiovascular Imaging, a journal from the American Heart Association.