Background Although several plausible biological mechanisms have been advanced for the association between greater physical stature and lower coronary heart disease (CHD) risk in prospective cohort studies, the importance of one of the principal artefactual explanations—reverse causality due to shrinkage—remains unresolved. To explore this issue, studies with repeat measurements of height are required, but, to date, such data have been lacking.
Objective To examine the possible relationship between height loss and future CHD.
Methods Data were analysed from the Whitehall II prospective cohort study of 3802 men and 1615 women who participated in a physical examination in 1985–8, had their height re-measured in 1997–9, and were then followed up for fatal and non-fatal CHD.
Results A mean follow-up of 7.4 years after the second height measurement gave rise to 69 CHD events in men and 18 in women. After adjustment for baseline CHD risk factors, greater loss of physical stature between survey and resurvey was associated with an increased risk of CHD in men (HR; 95% CI for a one SD increase: 1.24; 1.00 to 1.53) but not women (0.93; 0.58 to 1.50).
Conclusions Reverse causality due to shrinkage may contribute to the inverse association between a single measurement of height and later CHD in other studies.
- Aetiology outcome
- epidemiology FQ
- ischaemic heart disease
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Funding The Whitehall II study was supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), USA; the National Institute on Ageing (AG13196), USA; and the Agency for Health Care Policy Research (HS06516). David Batty is a Wellcome Trust Fellow; MM is a UK Medical Research Council Research Professor. MS is supported by the British Heart Foundation, JF by the MRC (grant number G8802774) and MK by the Academy of Finland. The Medical Research Council (MRC) Social and Public Health Sciences Unit receives funding from the UK MRC and the Chief Scientist Office at the Scottish Government Health Directorates.
Competing interests None.
Ethics approval This study was conducted with the approval of the The University College London Medical School committee on the ethics of human research.
Provenance and peer review Not commissioned; externally peer reviewed.