Skip to main content

Advertisement

SpringerLink
Log in

Adult height and the risk of cardiovascular disease among middle aged men and women in Japan

  • CARDIOVASCULAR DISEASE
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

An inverse association between height and risk of cardiovascular disease has been reported, but the evidence is limited for stroke subtypes, in particular in Asian populations. Further, few studies have examined how socioeconomic status in adulthood influence the relationship between height and risk of cardiovascular disease. This study examined the association between height and risks of stroke and coronary heart disease, and whether education level, an indicator of adult socioeconomic status, modify the effect of height on those risks, within a cohort of the Japan Public Health Center-based Prospective Study (JPHC Study). The hazard ratios for the incidence of cardiovascular disease associated with height were calculated by a 16-year follow-up of 15,564 Japanese men and women, aged 40–59. The hazard ratios were adjusted for age, gender, area, education, occupation and cardiovascular risk factors. Height was inversely associated with risks of total stroke, either hemorrhagic or ischemic stroke but not with coronary heart disease. The adjusted hazard ratios (95% confidence interval (CI)) of total stroke, hemorrhagic stroke, and ischemic stroke for a 1 SD height increments were 0.82 (95% CI: 0.74, 0.90), 0.80 (95% CI: 0.70, 0.92), and 0.83 (95% CI: 0.73, 0.95), respectively. No multiplicative interaction was observed between height and education level on stroke risk. Short stature was associated with increased risk of total stroke, either hemorrhagic or ischemic stroke, independent of adult socioeconomic status and cardiovascular risk factors, but not with risk of coronary heart disease in Japanese men and women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

BMI:

Body mass index

CHD:

Coronary heart disease

CI:

Confidence interval

DBP:

Diastolic blood pressure

FFQ:

Food frequency questionnaire

HR:

Hazard ratios

JPHC Study:

Japan Public Health Center Study

SBP:

Systolic blood pressure

References

  1. Marmot MG, Shipley MJ, Rose G. Inequalities in death–specific explanations of a general pattern? Lancet. 1984;1(8384):1003–6.

    Article  CAS  PubMed  Google Scholar 

  2. Kuh DL, Power C, Rodgers B. Secular trends in social class and sex differences in adult height. Int J Epidemiol. 1991;20(4):1001–9.

    Article  CAS  PubMed  Google Scholar 

  3. Barker DJ, Godfrey KM, Fall C, Osmond C, Winter PD, Shaheen SO. Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease. BMJ. 1991;303(6804):671–5.

    Article  CAS  PubMed  Google Scholar 

  4. Davey Smith G, Hart C, Upton M, Hole D, Gillis C, Watt G, et al. Height and risk of death among men and women: aetiological implications of associations with cardiorespiratory disease and cancer mortality. J Epidemiol Community Health. 2000;54(2):97–103.

    Article  CAS  PubMed  Google Scholar 

  5. Nystrom Peck AM. Childhood environment, intergenerational mobility, and adult health–evidence from Swedish data. J Epidemiol Community Health. 1992;46(1):71–4.

    Article  CAS  PubMed  Google Scholar 

  6. McCarron P, Okasha M, McEwen J, Smith GD. Height in young adulthood and risk of death from cardiorespiratory disease: a prospective study of male former students of Glasgow University, Scotland. Am J Epidemiol. 2002;155(8):683–7.

    Article  PubMed  Google Scholar 

  7. Gunnell D. Can adult anthropometry be used as a ‘biomarker’ for prenatal and childhood exposures? Int J Epidemiol. 2002;31(2):390–4.

    Article  PubMed  Google Scholar 

  8. Batty GD, Shipley MJ, Gunnell D, Huxley R, Kivimaki M, Woodward M, et al. Height, wealth, and health: an overview with new data from three longitudinal studies. Econ Hum Biol. 2009;7(2):137–52.

    Article  PubMed  Google Scholar 

  9. Silventoinen K, Sammalisto S, Perola M, Boomsma DI, Cornes BK, Davis C, et al. Heritability of adult body height: a comparative study of twin cohorts in eight countries. Twin Res. 2003;6(5):399–408.

    Article  PubMed  Google Scholar 

  10. Galobardes B, Smith GD, Lynch JW. Systematic review of the influence of childhood socioeconomic circumstances on risk for cardiovascular disease in adulthood. Ann Epidemiol. 2006;16(2):91–104.

    Article  PubMed  Google Scholar 

  11. Lu M, Ye W, Adami HO, Weiderpass E. Prospective study of body size and risk for stroke amongst women below age 60. J Intern Med. 2006;260(5):442–50.

    Article  CAS  PubMed  Google Scholar 

  12. Langenberg C, Shipley MJ, Batty GD, Marmot MG. Adult socioeconomic position and the association between height and coronary heart disease mortality: findings from 33 years of follow-up in the Whitehall Study. Am J Public Health. 2005;95(4):628–32.

    Article  PubMed  Google Scholar 

  13. Lee CM, Barzi F, Woodward M, Batty GD, Giles GG, Wong JW, et al. Adult height and the risks of cardiovascular disease and major causes of death in the Asia-Pacific region: 21,000 deaths in 510,000 men and women. Int J Epidemiol. 2009;38(4):1060–71.

    Article  PubMed  Google Scholar 

  14. Song YM, Smith GD, Sung J. Adult height and cause-specific mortality: a large prospective study of South Korean men. Am J Epidemiol. 2003;158(5):479–85.

    Article  PubMed  Google Scholar 

  15. Hozawa A, Murakami Y, Okamura T, Kadowaki T, Nakamura K, Hayakawa T, et al. Relation of adult height with stroke mortality in Japan: NIPPON DATA80. Stroke. 2007;38(1):22–6.

    Article  PubMed  Google Scholar 

  16. Hart RG, Benavente O. Stroke: part I. A clinical update on prevention. Am Fam Physician. 1999;59(9):2475–82, 85.

    Google Scholar 

  17. Liao Y, McGee DL, Kaufman JS, Cao G, Cooper RS. Socioeconomic status and morbidity in the last years of life. Am J Public Health. 1999;89(4):569–72.

    Article  CAS  PubMed  Google Scholar 

  18. Kuh D, Ben-Shlomo Y, Lynch J, Hallqvist J, Power C. Life course epidemiology. J Epidemiol Community Health. 2003;57(10):778–83.

    Article  CAS  PubMed  Google Scholar 

  19. Tsugane S, Sobue T. Baseline survey of JPHC study–design and participation rate. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases. J Epidemiol. 2001;11(6 Suppl):S24–9.

    CAS  PubMed  Google Scholar 

  20. Tsubono Y, Kobayashi M, Sasaki S, Tsugane S. Validity and reproducibility of a self-administered food frequency questionnaire used in the baseline survey of the JPHC Study Cohort I. J Epidemiol. 2003;13(1 Suppl):S125–33.

    PubMed  Google Scholar 

  21. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994;90(1):583–612.

    Google Scholar 

  22. Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, et al. Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I. Circulation. 2006;113(2):195–202.

    Article  CAS  PubMed  Google Scholar 

  23. Iso H, Baba S, Mannami T, Sasaki S, Okada K, Konishi M, et al. Alcohol consumption and risk of stroke among middle-aged men: the JPHC Study Cohort I. Stroke. 2004;35(5):1124–9.

    Article  PubMed  Google Scholar 

  24. Rich-Edwards JW, Manson JE, Stampfer MJ, Colditz GA, Willett WC, Rosner B, et al. Height and the risk of cardiovascular disease in women. Am J Epidemiol. 1995;142(9):909–17.

    CAS  PubMed  Google Scholar 

  25. Wannamethee SG, Shaper AG, Whincup PH, Walker M. Adult height, stroke, and coronary heart disease. Am J Epidemiol. 1998;148(11):1069–76.

    CAS  PubMed  Google Scholar 

  26. Glynn RJ, Rosner B. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol. 2005;162(10):975–82.

    Article  PubMed  Google Scholar 

  27. McCarron P, Greenwood R, Ebrahim S, Elwood P, Smith GD. Adult height is inversely associated with ischaemic stroke. The Caerphilly and Speedwell collaborative studies. J Epidemiol Community Health. 2000;54(3):239–40.

    Article  CAS  PubMed  Google Scholar 

  28. McCarron P, Hart CL, Hole D, Smith GD. The relation between adult height and haemorrhagic and ischaemic stroke in the Renfrew/Paisley study. J Epidemiol Community Health. 2001;55(6):404–5.

    Article  CAS  PubMed  Google Scholar 

  29. Parker DR, Lapane KL, Lasater TM, Carleton RA. Short stature and cardiovascular disease among men and women from two southeastern New England communities. Int J Epidemiol. 1998;27(6):970–5.

    Article  CAS  PubMed  Google Scholar 

  30. Njolstad I, Arnesen E, Lund-Larsen PG. Body height, cardiovascular risk factors, and risk of stroke in middle-aged men and women. A 14-year follow-up of the Finnmark Study. Circulation. 1996;94(11):2877–82.

    CAS  PubMed  Google Scholar 

  31. Lund Haheim L, Holme I, Hjermann I, Tonstad S. Risk-factor profile for the incidence of subarachnoid and intracerebral haemorrhage, cerebral infarction, and unspecified stroke during 21 years’ follow-up in men. Scand J Public Health. 2006;34(6):589–97.

    Article  PubMed  Google Scholar 

  32. Walker M, Shaper AG, Phillips AN, Cook DG. Short stature, lung function and risk of a heart attack. Int J Epidemiol. 1989;18(3):602–6.

    Article  CAS  PubMed  Google Scholar 

  33. Yarnell JW, Limb ES, Layzell JM, Baker IA. Height: a risk marker for ischaemic heart disease: prospective results from the Caerphilly and Speedwell Heart Disease Studies. Eur Heart J. 1992;13(12):1602–5.

    CAS  PubMed  Google Scholar 

  34. Hart CL, Hole DJ, Smith GD. The contribution of risk factors to stroke differentials, by socioeconomic position in adulthood: the Renfrew/Paisley Study. Am J Public Health. 2000;90(11):1788–91.

    Article  CAS  PubMed  Google Scholar 

  35. Kivimaki M, Smith GD, Juonala M, Ferrie JE, Keltikangas-Jarvinen L, Elovainio M, et al. Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study. Heart. 2006;92(4):474–80.

    Article  CAS  PubMed  Google Scholar 

  36. Brunner E, Shipley MJ, Blane D, Smith GD, Marmot MG. When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood. J Epidemiol Community Health. 1999;53(12):757–64.

    Article  CAS  PubMed  Google Scholar 

  37. Sorensen HT, Sabroe S, Rothman KJ, Gillman M, Steffensen FH, Fischer P, et al. Birth weight and length as predictors for adult height. Am J Epidemiol. 1999;149(8):726–9.

    CAS  PubMed  Google Scholar 

  38. Spencer J, Wang Z, Hoy W. Low birth weight and reduced renal volume in Aboriginal children. Am J Kidney Dis. 2001;37(5):915–20.

    Article  CAS  PubMed  Google Scholar 

  39. Silver LE, Decamps PJ, Korst LM, Platt LD, Castro LC. Intrauterine growth restriction is accompanied by decreased renal volume in the human fetus. Am J Obstet Gynecol. 2003;188(5):1320–5.

    Article  PubMed  Google Scholar 

  40. Hughson M, Farris AB 3rd, Douglas-Denton R, Hoy WE, Bertram JF. Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int. 2003;63(6):2113–22.

    Article  PubMed  Google Scholar 

  41. Eriksson JG, Forsen TJ, Kajantie E, Osmond C, Barker DJ. Childhood growth and hypertension in later life. Hypertension. 2007;49(6):1415–21.

    Article  CAS  PubMed  Google Scholar 

  42. Miura K, Nakagawa H, Tabata M, Morikawa Y, Nishijo M, Kagamimori S. Birth weight, childhood growth, and cardiovascular disease risk factors in Japanese aged 20 years. Am J Epidemiol. 2001;153(8):783–9.

    Article  CAS  PubMed  Google Scholar 

  43. Ben-Shlomo Y, Holly J, McCarthy A, Savage P, Davies D, Gunnell D, et al. An investigation of fetal, postnatal and childhood growth with insulin-like growth factor I and binding protein 3 in adulthood. Clin Endocrinol (Oxf). 2003;59(3):366–73.

    Article  CAS  Google Scholar 

  44. Johnsen SP, Hundborg HH, Sorensen HT, Orskov H, Tjonneland A, Overvad K, et al. Insulin-like growth factor (IGF) I, -II, and IGF binding protein-3 and risk of ischemic stroke. J Clin Endocrinol Metab. 2005;90(11):5937–41.

    Article  CAS  PubMed  Google Scholar 

  45. Silventoinen K, Zdravkovic S, Skytthe A, McCarron P, Herskind AM, Koskenvuo M, et al. Association between height and coronary heart disease mortality: a prospective study of 35,000 twin pairs. Am J Epidemiol. 2006;163(7):615–21.

    Article  PubMed  Google Scholar 

  46. Zhou B, Zhang X, Zhu A, Zhao L, Zhu S, Ruan L, et al. The relationship of dietary animal protein and electrolytes to blood pressure: a study on three Chinese populations. Int J Epidemiol. 1994;23(4):716–22.

    Article  CAS  PubMed  Google Scholar 

  47. Umesawa M, Sato S, Imano H, Kitamura A, Shimamoto T, Yamagishi K, et al. Relations between protein intake and blood pressure in Japanese men and women: the Circulatory Risk in Communities Study (CIRCS). Am J Clin Nutr. 2009;90(2):377–84.

    Article  CAS  PubMed  Google Scholar 

  48. Iso H, Stampfer MJ, Manson JE, Rexrode K, Hu F, Hennekens CH, et al. Prospective study of fat and protein intake and risk of intraparenchymal hemorrhage in women. Circulation. 2001;103(6):856–63.

    CAS  PubMed  Google Scholar 

  49. Smulyan H, Marchais SJ, Pannier B, Guerin AP, Safar ME, London GM. Influence of body height on pulsatile arterial hemodynamic data. J Am Coll Cardiol. 1998;31(5):1103–9.

    Article  CAS  PubMed  Google Scholar 

  50. Gillum RF, Makuc DM, Feldman JJ. Pulse rate, coronary heart disease, and death: the NHANES I Epidemiologic Follow-up Study. Am Heart J. 1991;121(1 Pt 1):172–7.

    Article  CAS  PubMed  Google Scholar 

  51. Kannel WB, Kannel C, Paffenbarger RS Jr, Cupples LA. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J. 1987;113(6):1489–94.

    Article  CAS  PubMed  Google Scholar 

  52. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006;113(9):1213–25.

    Article  CAS  PubMed  Google Scholar 

  53. Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007;50(1):197–203.

    Article  CAS  PubMed  Google Scholar 

  54. Kitamura A, Iso H, Iida M, Naito Y, Sato S, Jacobs DR, et al. Trends in the incidence of coronary heart disease and stroke and the prevalence of cardiovascular risk factors among Japanese men from 1963 to 1994. Am J Med. 2002;112(2):104–9.

    Article  PubMed  Google Scholar 

  55. Stringhini S, Sabia S, Shipley M, Brunner E, Nabi H, Kivimaki M, et al. Association of socioeconomic position with health behaviors and mortality. JAMA. Mar 24;303(12):1159–66.

Download references

Acknowledgments

This research was supported by grants-in-aid for cancer research and for the Third-Term Comprehensive Ten-Year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan. The authors wish to thank all staff members in each of the study areas and in the central office for their extensive efforts to conduct the baseline survey and follow-up.

Author information

Authors and Affiliations

  1. Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-9871, Osaka, Japan

    Kaori Honjo & Hiroyasu Iso

  2. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan

    Manami Inoue & Shoichiro Tsugane

Authors
  1. Kaori Honjo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroyasu Iso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manami Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shoichiro Tsugane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroyasu Iso.

Additional information

This study is conducted for the JPHC Study Group.

The JPHC Study Group members are listed in “Appendix” section.

Appendix

Appendix

Members of the Japan Public Health Center-based Prospective Study (JPHC Study; principal investigator: S. Tsugane) Group are: S. Tsugane, M. Inoue, T. Sobue, and T. Hanaoka, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo; J. Ogata, S. Baba, T. Mannami, and A. Okayama, National Cardiovascular Center, Suita; K. Miyakawa, F. Saito, A. Koizumi, Y. Sano, and I. Hashimoto, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y. Miyajima, N. Suzuki, S. Nagasawa, and Y. Furusugi, Akita Prefectural Yokote Public Health Center, Yokote; H. Sanada, Y. Hatayama, F. Kobayashi, H. Uchino, Y. Shirai, T. Kondo, R. Sasaki, Y. Watanabe, and Y. Miyagawa, Nagano Prefectural Saku Public Health Center, Saku; Y. Kishimoto, E. Takara, T. Fukuyama, M. Kinjo, M. Irei, and H. Sakiyama, Okinawa Prefectural Chubu Public Health Center, Okinawa; K. Imoto, H. Yazawa, T. Seo, A. Seiko, F. Ito, and F. Shoji, Katsushika Public Health Center, Tokyo; A. Murata, K. Minato, K. Motegi, and T. Fujieda, Ibaraki Prefectural Mito Public Health Center, Mito; K. Matsui, T. Abe, M. Katagiri, and M. Suzuki, Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Kashiwazaki and Nagaoka; M. Doi, A. Terao, and Y. Ishikawa, Kochi Prefectural Chuo-higashi Public Health Center, Tosayamada; H. Sueta, H. Doi, M. Urata, N. Okamoto, and F. Ide, Nagasaki Prefectural Kamigoto Public Health Center, Arikawa; H. Sakiyama, N. Onga, and H. Takaesu, Okinawa Prefectural Miyako Public Health Center, Hirara; F. Horii, I. Asano, H. Yamaguchi, K. Aoki, S. Maruyama, and M. Ichii, Osaka Prefectural Suita Public Health Center, Suita; S. Matsushima and S. Natsukawa, Saku General Hospital, Usuda; M. Akabane, Tokyo University of Agriculture, Tokyo; M. Konishi, and K. Okada, Ehime University, Ehime; H. Iso, Osaka University, Suita; Y. Honda and K. Yamagishi, Tsukuba University, Tsukuba; H. Sugimura, Hamamatsu University, Hamamatsu; Y. Tsubono, Tohoku University, Sendai; M. Kabuto, National Institute for Environmental Studies, Tsukuba; S. Tominaga, Aichi Cancer Center Research Institute, Nagoya; M. Iida and W. Ajiki, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S. Sato, Osaka Medical Center for Health Science and Promotion, Osaka; N. Yasuda, Kochi University, Nankoku; S. Kono, Kyushu University, Fukuoka; K. Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita; Y. Takashima, Kyorin University, Mitaka; E. Maruyama, Kobe University, Kobe; M. Yamaguchi, Y. Matsumura, S. Sasaki, and S. Watanabe, National Institute of Health and Nutrition, Tokyo; T. Kadowaki, Tokyo University, Tokyo; Y. Kawaguchi, Tokyo Medical and Dental University, Tokyo; and H. Shimizu, Sakihae Institute, Gifu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Honjo, K., Iso, H., Inoue, M. et al. Adult height and the risk of cardiovascular disease among middle aged men and women in Japan. Eur J Epidemiol 26, 13–21 (2011). https://doi.org/10.1007/s10654-010-9515-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10654-010-9515-8

Keywords

Search

Navigation