Langenberg Claudia, Hardy Rebecca, Breeze Elizabeth, Kuh Diana, Wadsworth Michael E J
Department of Epidemiology and Public Health, University College London Medical School, 1-19 Torrington Place, London WC1E 6BT, UK.
Int J Epidemiol. 2005 Aug;34(4):905-13. doi: 10.1093/ije/dyi071. Epub 2005 Apr 15.
Previous cross-sectional analyses of this cohort have shown that short height and leg length are associated with higher pulse pressure and systolic blood pressure in middle age. It is unclear how these adult measures of childhood growth influence the change in blood pressure as it increases with age.
Multilevel models were fitted to investigate associations between components of height and the change in blood pressure between 36, 43, and 53 years in a prospective national cohort of 1472 men and 1563 women followed-up since birth in 1946.
Shorter height and leg length, but not trunk length, were associated with higher blood pressure, similarly in men and women. Longitudinal analyses showed that the effects of both height and leg length on pulse pressure and systolic blood pressure became significantly stronger with age. For example, the change in systolic blood pressure was found to be -0.021 mm Hg (95% confidence interval -0.029 to -0.013) per year lower for every centimetre increase in leg length (P < or = 0.001). In other words, the increase in systolic blood pressure over a 10 year period of a participant whose legs were 10 centimetres shorter was 2.1 mm Hg higher (P < or = 0.001), compared with a taller participant. Associations were independent of a number of potential confounders.
These results support the hypothesis that short people may be more susceptible to the effects of ageing on the arterial tree. Childhood growth may contribute to the tracking of cardiovascular risk throughout life.
此前对该队列的横断面分析表明,身高较矮和腿长较短与中年时较高的脉压和收缩压相关。目前尚不清楚这些儿童期生长的成人指标如何影响随着年龄增长而升高的血压变化。
采用多水平模型,对1946年出生后就开始随访的1472名男性和1563名女性的全国前瞻性队列进行研究,以调查身高各组成部分与36岁、43岁和53岁时血压变化之间的关联。
身高较矮和腿长较短,但躯干长度并非如此,与较高的血压相关,男性和女性情况相似。纵向分析表明,身高和腿长对脉压和收缩压的影响随着年龄的增长而显著增强。例如,发现腿长每增加1厘米,收缩压每年降低-0.021毫米汞柱(95%置信区间为-0.029至-0.013)(P≤0.001)。换句话说,与腿较长的参与者相比,腿短10厘米的参与者在10年期间收缩压的升高要高2.1毫米汞柱(P≤0.001)。这些关联独立于许多潜在的混杂因素。
这些结果支持了这样的假设,即身材矮小的人可能更容易受到衰老对动脉系统影响的作用。儿童期生长可能会导致一生中心血管风险的追踪。