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Short stature is associated with coronary heart disease: a systematic review of the literature and a meta-analysis

Tuula A. Paajanen, Niku K.J. Oksala, Pekka Kuukasjärvi, Pekka J. Karhunen
DOI: http://dx.doi.org/10.1093/eurheartj/ehq155 First published online: 8 June 2010

Abstract

Aims The aim of this study was to assess the relationship between short stature and coronary heart disease (CHD) morbidity and mortality.

Methods and results We performed a systematic search from MEDLINE, PREMEDLINE, and All EBM Reviews as well as from a reference list of relevant articles. We used SPICO (Study design, Patient, Intervention, Control-intervention, Outcome) criteria. The methodological quality of studies was analysed by modified Borghoust criteria. From a total of 1907 articles, we selected 52 studies comprising population-based follow-up studies and patient cohorts followed after a CHD event, as well as case-control studies with height either as a continuous or categorical variable, totalling 3 012 747 individuals. The short ones were below 160.5 cm and tall ones over 173.9 cm on average. Among the shortest height category, the relative risks were 1.35 (95% CI 1.25–1.44) for all-cause mortality, 1.55 (1.37–1.74) for all cardiovascular disease (CVD) mortality, 1.49 (1.33–1.67) for CHD, and 1.52 (1.28–1.81) for myocardial infarction when compared with those within the highest height category. The mean relative risk was 1.46 (1.37–1.55). Short stature was associated with increased cardiovascular morbidity and mortality in both genders.

Conclusion The relationship between short stature and CVD appears to be a real one. On the basis of comparison, adults within the shortest category had an ∼50% higher risk of CHD morbidity and mortality than tall individuals.

  • Short stature
  • Height
  • Coronary heart disease
  • Systematic review
  • Meta-analysis
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