Wannamethee S Goya, Papacosta Olia, Lennon Lucy, Hingorani Aroon, Whincup Peter
Department Primary Care and Population Health, UCL London, United Kingdom.
Institute of Cardiovascular Sciences, UCL, London, United Kingdom.
Int J Cardiol Heart Vasc. 2021 Jul 8;35:100835. doi: 10.1016/j.ijcha.2021.100835. eCollection 2021 Aug.
Taller stature has been associated with increased risk of atrial fibrillation (AF). AF and heart failure (HF) often co-occur but the association between height and risk of HF in older adults has not been well studied. We have examined the association between height and incident AF and incident HF in older adults.
Prospective study of 3346 men aged 60-79 years with no diagnosed HF, myocardial infarction or stroke at baseline (1998-2000) followed up for a mean period of 16 years, in whom there were 294 incident HF cases and 456 incident AF. Men were divided into 5 height groups: <168.2, 168.2-172.5, 172.6-176.9, 177.0-183.0 and >183.0 cms based on the 25th, 50th, 75th and 95th centiles distribution of height.
CVD risk factors tended to decrease with increasing height but a positive association was seen between height and electrocardiographic QRS duration and incident AF. Both short stature (<168.2 cm) and tall stature (>183.0 cm) was associated with significantly increased risk of HF in age-adjusted analysis compared to those in the second height quartile [HR (95 %CI) = 1.62 (1.15, 2.26) and 2.04 (1.23, 3.39) respectively]. In short men the increased risk remained after adjustment for adverse CVD risk factors; in tall men the association was largely associated with AF and QRS duration.
Tall stature is associated with significantly increased risk of AF leading to increased risk of HF. Short stature was associated with increased HF risk which was not explained by known adverse CVD risk factors.
较高的身高与心房颤动(AF)风险增加相关。AF和心力衰竭(HF)常同时出现,但老年人身高与HF风险之间的关联尚未得到充分研究。我们研究了老年人身高与新发AF和新发HF之间的关联。
对3346名年龄在60 - 79岁之间、基线时(1998 - 2000年)未诊断出HF、心肌梗死或中风的男性进行前瞻性研究,平均随访16年,其中有294例新发HF病例和456例新发AF。根据身高的第25、50、75和95百分位数分布,将男性分为5个身高组:<168.2、168.2 - 172.5、172.6 - 176.9、177.0 - 183.0和>183.0厘米。
心血管疾病(CVD)危险因素往往随着身高增加而降低,但身高与心电图QRS波时限及新发AF之间存在正相关。与第二身高四分位数的男性相比,在年龄调整分析中,身材矮小(<168.2厘米)和身材高大(>183.0厘米)均与HF风险显著增加相关[风险比(95%置信区间)分别为1.62(1.15,2.26)和2.04(1.23,3.39)]。在矮个子男性中,调整不利的CVD危险因素后,风险增加仍然存在;在高个子男性中,这种关联主要与AF和QRS波时限有关。
身材高大与AF风险显著增加相关,导致HF风险增加。身材矮小与HF风险增加相关,这不能用已知的不利CVD危险因素来解释。