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IJE Advance Access originally published online on March 6, 2009
International Journal of Epidemiology 2009 38(4):1060-1071; doi:10.1093/ije/dyp150
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

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

Crystal Man Ying Lee1,*, Federica Barzi1, Mark Woodward1,2, G David Batty3, Graham G Giles4, Jean Woo Wong5, Konrad Jamrozik6, Tai Hing Lam7, Hirotsugu Ueshima8, Hyeon Chang Kim9, Dong Feng Gu10, Mary Schooling7, Rachel R Huxley1 for The Asia Pacific Cohort Studies Collaboration

1The George Institute for International Health, University of Sydney, Sydney, Australia.
2Mount Sinai Medical Center, New York, USA.
3MRC Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
4Cancer Control Research Institute, The Cancer Council, Melbourne, Australia.
5Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
6School of Public Health and Clinical Practice, University of Adelaide, Adelaide, Australia.
 7 Department of Community Medicine, The University of Hong Kong, Hong Kong, China.
 8 Department of Health Science, Shiga University of Medical Science, Shiga, Japan.
 9 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
10Department of Evidence-based Medicine, Fu Wai Hospital, Beijing, China.

*Corresponding author. Crystal Man Ying Lee, The George Institute for International Health, PO Box M201, Missenden Road, Sydney NSW 2050, Australia. E-mail: clee{at}george.org.au


   Abstract

Background In Caucasian populations, adult height is inversely associated with cardiovascular disease (CVD) risk and positively related to some cancers. However, there are few data from Asian populations and from women. We sought to determine the sex- and region-specific associations between height and cardiovascular outcomes, and deaths due to cancer, respiratory and injury in populations from the Asia-Pacific region.

Methods Thirty-nine studies from the Asia Pacific Cohort Studies Collaboration database were included. We used Cox proportional hazard regression models to estimate the associations between height and pre-specified outcomes.

Results A total of 510 800 participants with 21 623 deaths were included. Amongst men, inverse linear associations were observed between height and coronary heart disease (CHD), stroke, CVD, injury and total mortality. The hazard ratios [95% confidence intervals, (CI)] for a 1-SD (= 6 cm) increment in height ranged from 0.85 (0.80–0.91) for injury to 0.97 (0.95–0.98) for total mortality. Similar trends were found between height and CHD, haemorrhagic stroke and CVD in women. A positive linear association was observed between height and cancer mortality. For each standard deviation greater height, the risk of cancer was increased by 5% (2–8%) and 9% (5–14%) in men and women, respectively. No regional difference was observed between Asian and Australasian cohorts. Adjusting for markers of education did not alter the results.

Conclusions The opposing relationships of height with CVD and cancer suggest that care is required in setting national policies on childhood nutrition lest they have unintended consequences on the incidence of major non-communicable diseases.


Keywords Body height, cardiovascular disease, cancer, respiratory disease, injury, mortality

Accepted 29 January 2009


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