Wannamethee S G, Shaper A G, Whincup P H, Walker M
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, England.
Am J Epidemiol. 1998 Dec 1;148(11):1069-76. doi: 10.1093/oxfordjournals.aje.a009584.
An inverse relation between adult height and risk of coronary heart disease (CHD) has been reported in many studies, but the association between adult height and stroke remains uncertain. The authors examined the relation between adult height and risk of stroke and CHD in a prospective study of 7,735 men drawn from general medical practices in 24 towns in England, Wales, and Scotland. The men were followed up for an average of 16.8 years (range, 15.5-18.0 years) between 1978 and 1995. During this period, there were 351 major stroke events (63 fatal, 288 nonfatal) and 1,093 major CHD events (465 fatal, 628 nonfatal). The mean height of the men was 173.3 cm. Total stroke risk was increased only in the men who fell into the lowest quintile of the height distribution (<167.7 cm), with little difference being seen between the other groups. When data were examined separately for fatal and nonfatal events, no relation was seen with nonfatal stroke. An apparent inverse association was seen with fatal stroke, even after adjustment for a wide range of confounding variables, but the number of deaths was small and the trend was not statistically significant (p = 0.17). By contrast, a significant inverse relation was seen between height and risk of major CHD events: Risk decreased progressively with increasing height, even after full adjustment (highest quintile vs. lowest: relative risk (RR) = 0.74, 95% confidence interval (CI) 0.59-0.91; test for trend: p < 0.001). A stronger inverse association was seen with nonfatal CHD events (RR = 0.64, 95% CI 0.49-0.84) than with fatal CHD events (RR = 0.82, 95% CI 0.60-1.11). This study confirms the finding of an inverse association between height and CHD. The inverse association seen for fatal stroke but not nonfatal stroke suggests that height may be related to specific subtypes of stroke. There are different patterns of association between height and stroke and height and CHD. If the apparent association between short stature and increased risk of fatal stroke is confirmed in other prospective studies, this would suggest that different mechanisms underlie the effects of height on stroke and CHD.
许多研究报告称成人身高与冠心病（CHD）风险之间存在负相关关系，但成人身高与中风之间的关联仍不明确。作者在一项对来自英格兰、威尔士和苏格兰24个城镇普通医疗诊所的7735名男性进行的前瞻性研究中，考察了成人身高与中风及冠心病风险之间的关系。在1978年至1995年期间，这些男性平均随访了16.8年（范围为15.5 - 18.0年）。在此期间，发生了351例重大中风事件（63例死亡，288例非致命）和1093例重大冠心病事件（465例死亡，628例非致命）。这些男性的平均身高为173.3厘米。仅身高分布处于最低五分位数（<167.7厘米）的男性总中风风险增加，其他组之间差异不大。当分别检查致命和非致命事件的数据时，未发现与非致命中风有关联。即使在对一系列混杂变量进行调整后，仍观察到与致命中风存在明显的负相关，但死亡人数较少且趋势无统计学意义（p = 0.17）。相比之下，身高与重大冠心病事件风险之间存在显著的负相关关系：即使在进行全面调整后，风险也随着身高增加而逐渐降低（最高五分位数与最低五分位数相比：相对风险（RR）= 0.74，95%置信区间（CI）0.59 - 0.91；趋势检验：p < 0.001）。与非致命冠心病事件（RR = 0.64，95% CI 0.49 - 0.84）相比，与致命冠心病事件（RR = 0.82，95% CI 0.60 - 1.11）的负相关更强。这项研究证实了身高与冠心病之间存在负相关的发现。在致命性中风而非非致命性中风中观察到的负相关表明，身高可能与中风的特定亚型有关。身高与中风以及身高与冠心病之间存在不同的关联模式。如果在其他前瞻性研究中证实身材矮小与致命性中风风险增加之间存在明显关联，这将表明身高对中风和冠心病影响的潜在机制不同。
