Tall Story? Less Coronary Calcium Hints at CV Benefits of Height

Shelley Wood

December 13, 2013

MINNEAPOLIS, MN — Researchers believe they've found a new clue to explain the inverse association long observed between adult height and coronary heart disease. In an analysis of over 2700 participants in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study , Dr Michael Miedema (Minneapolis Heart Institute, MN) and colleagues found that the tallest subjects in the study had the least amount of coronary artery calcium (CAC)[1].

Their study is published online December 11, 2013 in Circulation: Cardiovascular Imaging.

Speaking with heartwire , Miedema stressed that he does not think the finding should enter into risk-factor calculations, despite the fact that the association held true after adjustment for all other common CVD risk factors.

"We're not going to be saying, oh, you're short, we better put you on a statin," he quipped. Instead, the finding likely helps bolster the theory that the higher risk reported in shorter subjects likely is mediated through plaque accumulation.

For their analysis, Miedema et al adjusted for age, race, field center, waist circumference, smoking, alcohol, physical activity, systolic blood pressure, antihypertensive medications, diabetes, diabetic medications, LDL cholesterol, HDL cholesterol, lipid-lowering medications, and income. When subject were divided into quartiles by height, the tallest subjects were found to have 30% lower odds of having prevalent coronary artery calcium, as compared with subjects in the lowest quartile by height.

To heartwire , Miedema hypothesized that height is likely a marker for environmental and other factors that are conducive to health, including better nutrition. Others have hypothesized that the blood-pressure physics and hemodynamics may at least partially explain the benefits of a taller frame; the current study suggests other factors are also at play.

"If I had to guess, I'd say it is probably an environmental issue, experienced during the 'growing years,' " that affects both adult height and future risk of coronary artery disease, he said.

Of note, the inverse association between height and CAC was not seen in the study's subgroup of 528 African Americans, a finding that supports research in other nonwhite ethnic groups in Korea, Japan, and Iran that have failed to find a link between adult height and coronary heart disease.

The authors had no disclosures.


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