Height loss in older men associated with increased risk of heart disease, death

December 11, 2006

Men who lose 3 centimeters or more of height as they age have an increased risk of death and of coronary heart diseases events, according to a report in the December 11/25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Changes in bone, muscles and joints typically lead men and women to become shorter as they age, according to background information in the article. Although a small amount of height loss is normal and probably not associated with any disease, more significant height loss may be a sign of osteoporosis (thinning of the bones). Substantial height loss can affect breathing and digestive functions, leading to poor eating habits and weight loss, and may be associated with sarcopenia, the loss of muscle mass.

S. Goya Wannamethee, Ph.D., Royal Free and University College Medical School, London, and colleagues studied 4,213 men who originally enrolled in the British Regional Heart Study between 1978 and 1980. Follow-up examinations were conducted 20 years later, when the men were 60 to 79 years old. At that time, the men completed a questionnaire providing details about their lifestyle and medical history. They were asked to describe their current health status--excellent, good, fair or poor--and whether their physician had ever told them they had cardiovascular disease or a number of other conditions. Participants' height and weight were measured both at the beginning of the study and at the 20-year follow-up; they were monitored through 2004 to see if they had developed cardiovascular disease, and deaths were tracked through 2005.

Between the initial examination and the 20-year follow-up, the men lost an average of 1.67 centimeters of height. The researchers divided the participants into four groups based on how much their height changed: 1,471 lost less than 1 centimeter; 1,330 lost between 1 and 1.9 centimeters; 807 lost between 2 and 2.9 centimeters; and 605 were 3 centimeters shorter or more. During the average of five years that they were followed after that, 760 men died. Risk of death increased with height loss and was substantially higher in men who lost 3 centimeters or more--they were 64 percent more likely to die during the course of the study than those who lost less than 1 centimeter. Most of the additional deaths in men who had lost height were attributable to cardiovascular disease, respiratory disease or other non-cancer diseases. Height loss was also associated with an increased risk for coronary heart disease events, even after the researchers adjusted for prior cardiovascular disease and its known risk factors.

It is unclear exactly which mechanisms are responsible for the association between height loss, illness and death. Osteoporosis increases the risk of death and may play a role; however, it typically causes a loss of 6 centimeters or more of height. "The significantly increased risk of all-cause mortality in men with a height loss of 3 centimeters or more was observed even after exclusion of men with a height loss of 4 centimeters or more," a total of 283 men, the authors write. "Thus, the increased mortality risk was already seen in men with a height loss in the range of 3 centimeters to 4 centimeters and was not solely attributable to extreme height loss." There could also be an underlying mechanism that contributes to both bone loss, which leads to height loss, and coronary heart and other diseases.
(Arch Intern Med. 2006;166:2546-2552. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: The British Regional Heart Study is a British Heart Foundation Research Group and receives support from the Department of Health (England). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.

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