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Association between womenʼs middle-age height loss and greater risk of death

Women who experience greater height loss during middle age may be at higher risk of death, Swedish research suggests.

Scientists previously found that shorter people might have an increased risk of heart disease, with researchers saying the two appeared to be linked not just by lifestyle but by genes.

Now, researchers say height loss in middle age, at least among northern European women, appears to be linked to a greater risk of death, including from cardiovascular disease.

“Height loss is probably not a risk factor per se but is rather a marker for other true causes,” said Dr Sofia Klingberg of the University of Gothenburg, a co-author of the research. Writing in the journal BMJ Open, researchers report how they analysed data from 2,406 Swedish and Danish women born between 1908 and 1952 who were involved with long-term studies in those countries.

Height measurements were taken at the start of the studies, when the average age of the women was 47 and 44 respectively, and about 10 to 13 years later. After that point deaths among participants were tracked for a further 17 to 19 years: 625 participants died during the follow-up period, 157 of the deaths due to cardiovascular disease and 37 to stroke. Overall the women lost an average of 0.8cm in height over 11.4 years.

“People lose height as they get older because of changes in the spine, for example because of reduced height of the discs between the vertebra in the spine,” said Klingberg, adding compression fractures in the spine and changes in posture can result in further height loss.

When the team considered the two groups together, and took into account factors such as age, smoking, and height and weight at the start of the study, they found that each centimetre of height the women lost between the two measurements was associated with a 15% greater risk of death from any cause, while those who lost more than 2cm in height between measurements had a 74% increased risk of death from any cause and at any point in the future.

The team found similar trends when they looked at deaths due to cardiovascular disease, finding a 21% increased risk of death for every centimetre lost, and more than twice the risk of death for those who lost more than 2cm in height. The increased risk of death from stroke associated with height loss was even greater, however the team caution that – as only a small number of participants died from stroke – the figures should be treated with caution. In a further twist, the team found women who engaged in regular and high-intensity physical activity in their leisure time showed less height loss than those who did four hours or more low-impact exercise a week.

“High physical activity is probably linked to reduced height loss, both through reduced reduction of the age-related bone loss and through increased muscle strength and a more upright posture,” said Klingberg.

But, she added, the link between height loss and risk of death remained even once exercise was taken into account.

The Guardian notes that the research is the latest to suggest a link between height loss and mortality, although results for women have previously been mixed. Klingberg said keeping tabs on height loss could be beneficial, with a decrease in height potentially prompting a health check-up.

Study details

Loss of height predicts total and cardiovascular mortality: a cohort study of northern European women

Sofia Klingberg, Kirsten Mehlig, Rojina Dangol, Cecilia Björkelund, Berit Lilienthal Heitmann, Lauren Lissner

Published in BMJ Open, August, Volume 11, Issue 8

Abstract

Objective To examine height changes in middle-aged northern European women in relation to overall and cardiovascular mortality.

Design Population-based cohort studies with longitudinally measured heights and register-based mortality.

Participants Population-based samples of 2406 Swedish and Danish women born on selected years in 1908–1952, recruited to baseline examinations at ages 30–60, and re-examined 10–13 years later.

Main outcome measure Total and cardiovascular disease (CVD) specific mortality during 17–19 years of follow-up after last height measure.

Results For each 1 cm height loss during 10–13 years, the HR (95% CI) for total mortality was 1.14 (1.05 to 1.23) in Swedish women and 1.21 (1.09 to 1.35) in Danish women, independent of key covariates. Low height and high leisure time physical activity at baseline were protective of height loss, independent of age. Considering total mortality, the HR for major height loss, defined as height loss greater than 2 cm, were 1.74 (1.32 to 2.29) in Swedish women and 1.80 (1.27 to 2.54) in Danish women.

Pooled analyses indicated that height loss was monotonically associated with an increased mortality, confirming a significant effect above 2 cm height loss. For cause-specific mortality, major height loss was associated with a HR of 2.31 (1.09 to 4.87) for stroke mortality, 2.14 (1.47 to 3.12) for total CVD mortality and 1.71 (1.28 to 2.29) for mortality due to causes other than CVD.

Conclusion Height loss is a marker for excess mortality in northern European women. Specifically the hazard of CVD mortality is increased in women with height loss during middle age, and the results suggest that the strongest cause-specific endpoint may be stroke mortality. The present findings suggest attention to height loss in early and mid-adulthood to identify women at high risk of CVD, and that regular physical activity may prevent early onset height loss.

 

Study links women’s middle-age height loss with greater risk of death (Open access)

 

BMJ Open article – Loss of height predicts total and cardiovascular mortality: a cohort study of northern European women (Open access)

 

See more from MedicalBrief archives:

 

BMI alternatives: Simpler and better predictors of mortality and disease

 

Childhood height may be a marker for stroke risk later

 

Cardiac risk with high waist to hip ratio

 

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