Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Feb;54(2):97–103. doi: 10.1136/jech.54.2.97

Height and risk of death among men and women: aetiological implications of associations with cardiorespiratory disease and cancer mortality

G D Smith 1, C Hart 1, M Upton 1, D Hole 1, C Gillis 1, G Watt 1, V Hawthorne 1
PMCID: PMC1731616  PMID: 10715741

Abstract

OBJECTIVES—Height is inversely associated with cardiovascular disease mortality risk and has shown variable associations with cancer incidence and mortality. The interpretation of findings from previous studies has been constrained by data limitations. Associations between height and specific causes of death were investigated in a large general population cohort of men and women from the West of Scotland.
DESIGN—Prospective observational study.
SETTING—Renfrew and Paisley, in the West of Scotland.
SUBJECTS—7052 men and 8354 women aged 45-64 were recruited into a study in Renfrew and Paisley, in the West of Scotland, between 1972 and 1976. Detailed assessments of cardiovascular disease risk factors, morbidity and socioeconomic circumstances were made at baseline.
MAIN OUTCOME MEASURES—Deaths during 20 years of follow up classified into specific causes.
RESULTS—Over the follow up period 3347 men and 2638 women died. Height is inversely associated with all cause, coronary heart disease, stroke, and respiratory disease mortality among men and women. Adjustment for socioeconomic position and cardiovascular risk factors had little influence on these associations. Height is strongly associated with forced expiratory volume in one second (FEV1) and adjustment for FEV1 considerably attenuated the association between height and cardiorespiratory mortality. Smoking related cancer mortality is not associated with height. The risk of deaths from cancer unrelated to smoking tended to increase with height, particularly for haematopoietic, colorectal and prostate cancers. Stomach cancer mortality was inversely associated with height. Adjustment for socioeconomic position had little influence on these associations.
CONCLUSION—Height serves partly as an indicator of socioeconomic circumstances and nutritional status in childhood and this may underlie the inverse associations between height and adulthood cardiorespiratory mortality. Much of the association between height and cardiorespiratory mortality was accounted for by lung function, which is also partly determined by exposures acting in childhood. The inverse association between height and stomach cancer mortality probably reflects Helicobacter pylori infection in childhood resulting in—or being associated with—shorter height. The positive associations between height and several cancers unrelated to smoking could reflect the influence of calorie intake during childhood on the risk of these cancers.


Keywords: height; cancer; cardiorespiratory disease

Full Text

The Full Text of this article is available as a PDF (143.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barker D. J., Coggon D., Osmond C., Wickham C. Poor housing in childhood and high rates of stomach cancer in England and Wales. Br J Cancer. 1990 Apr;61(4):575–578. doi: 10.1038/bjc.1990.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bonelli L., Vitale V., Bistolfi F., Landucci M., Bruzzi P. Hodgkin's disease in adults: association with social factors and age at tonsillectomy. A case-control study. Int J Cancer. 1990 Mar 15;45(3):423–427. doi: 10.1002/ijc.2910450307. [DOI] [PubMed] [Google Scholar]
  3. Cats A., Dullaart R. P., Kleibeuker J. H., Kuipers F., Sluiter W. J., Hardonk M. J., de Vries E. G. Increased epithelial cell proliferation in the colon of patients with acromegaly. Cancer Res. 1996 Feb 1;56(3):523–526. [PubMed] [Google Scholar]
  4. Chan J. M., Stampfer M. J., Giovannucci E., Gann P. H., Ma J., Wilkinson P., Hennekens C. H., Pollak M. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science. 1998 Jan 23;279(5350):563–566. doi: 10.1126/science.279.5350.563. [DOI] [PubMed] [Google Scholar]
  5. Cook N. R., Hebert P. R., Satterfield S., Taylor J. O., Buring J. E., Hennekens C. H. Height, lung function, and mortality from cardiovascular disease among the elderly. Am J Epidemiol. 1994 Jun 1;139(11):1066–1076. doi: 10.1093/oxfordjournals.aje.a116950. [DOI] [PubMed] [Google Scholar]
  6. Forman D., Newell D. G., Fullerton F., Yarnell J. W., Stacey A. R., Wald N., Sitas F. Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. BMJ. 1991 Jun 1;302(6788):1302–1305. doi: 10.1136/bmj.302.6788.1302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Frankel S., Gunnell D. J., Peters T. J., Maynard M., Davey Smith G. Childhood energy intake and adult mortality from cancer: the Boyd Orr Cohort Study. BMJ. 1998 Feb 14;316(7130):499–504. doi: 10.1136/bmj.316.7130.499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gunnell D. J., Davey Smith G., Frankel S., Nanchahal K., Braddon F. E., Pemberton J., Peters T. J. Childhood leg length and adult mortality: follow up of the Carnegie (Boyd Orr) Survey of Diet and Health in Pre-war Britain. J Epidemiol Community Health. 1998 Mar;52(3):142–152. doi: 10.1136/jech.52.3.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gunnell D. J., Smith G. D., Holly J. M., Frankel S. Leg length and risk of cancer in the Boyd Orr cohort. BMJ. 1998 Nov 14;317(7169):1350–1351. doi: 10.1136/bmj.317.7169.1350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hankinson S. E., Willett W. C., Colditz G. A., Hunter D. J., Michaud D. S., Deroo B., Rosner B., Speizer F. E., Pollak M. Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet. 1998 May 9;351(9113):1393–1396. doi: 10.1016/S0140-6736(97)10384-1. [DOI] [PubMed] [Google Scholar]
  11. Hansson L. E., Baron J., Nyrén O., Bergström R., Wolk A., Lindgren A., Adami H. O. Early-life risk indicators of gastric cancer. A population-based case-control study in Sweden. Int J Cancer. 1994 Apr 1;57(1):32–37. doi: 10.1002/ijc.2910570107. [DOI] [PubMed] [Google Scholar]
  12. Hawthorne V. M., Watt G. C., Hart C. L., Hole D. J., Smith G. D., Gillis C. R. Cardiorespiratory disease in men and women in urban Scotland: baseline characteristics of the Renfrew/Paisley (midspan) study population. Scott Med J. 1995 Aug;40(4):102–107. doi: 10.1177/003693309504000402. [DOI] [PubMed] [Google Scholar]
  13. Hebert P. R., Ajani U., Cook N. R., Lee I. M., Chan K. S., Hennekens C. H. Adult height and incidence of cancer in male physicians (United States). Cancer Causes Control. 1997 Jul;8(4):591–597. doi: 10.1023/a:1018442329319. [DOI] [PubMed] [Google Scholar]
  14. Hole D. J., Watt G. C., Davey-Smith G., Hart C. L., Gillis C. R., Hawthorne V. M. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996 Sep 21;313(7059):711–716. doi: 10.1136/bmj.313.7059.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Juul A., Bang P., Hertel N. T., Main K., Dalgaard P., Jørgensen K., Müller J., Hall K., Skakkebaek N. E. Serum insulin-like growth factor-I in 1030 healthy children, adolescents, and adults: relation to age, sex, stage of puberty, testicular size, and body mass index. J Clin Endocrinol Metab. 1994 Mar;78(3):744–752. doi: 10.1210/jcem.78.3.8126152. [DOI] [PubMed] [Google Scholar]
  16. Kuh D. L., Power C., Rodgers B. Secular trends in social class and sex differences in adult height. Int J Epidemiol. 1991 Dec;20(4):1001–1009. doi: 10.1093/ije/20.4.1001. [DOI] [PubMed] [Google Scholar]
  17. Kuh D., Smith G. D. When is mortality risk determined? Historical insights into a current debate. Soc Hist Med. 1993 Apr;6(1):101–123. [PubMed] [Google Scholar]
  18. La Vecchia C., Negri E., Parazzini F., Boyle P., D'Avanzo B., Levi F., Gentile A., Franceschi S. Height and cancer risk in a network of case-control studies from northern Italy. Int J Cancer. 1990 Feb 15;45(2):275–279. doi: 10.1002/ijc.2910450212. [DOI] [PubMed] [Google Scholar]
  19. Leon D. A., Smith G. D., Shipley M., Strachan D. Adult height and mortality in London: early life, socioeconomic confounding, or shrinkage? J Epidemiol Community Health. 1995 Feb;49(1):5–9. doi: 10.1136/jech.49.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Malaty H. M., Graham D. Y. Importance of childhood socioeconomic status on the current prevalence of Helicobacter pylori infection. Gut. 1994 Jun;35(6):742–745. doi: 10.1136/gut.35.6.742. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mann S. L., Wadsworth M. E., Colley J. R. Accumulation of factors influencing respiratory illness in members of a national birth cohort and their offspring. J Epidemiol Community Health. 1992 Jun;46(3):286–292. doi: 10.1136/jech.46.3.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Martin T. R., Feldman H. A., Fredberg J. J., Castile R. G., Mead J., Wohl M. E. Relationship between maximal expiratory flows and lung volumes in growing humans. J Appl Physiol (1985) 1988 Aug;65(2):822–828. doi: 10.1152/jappl.1988.65.2.822. [DOI] [PubMed] [Google Scholar]
  23. Njølstad I., Arnesen E., Lund-Larsen P. G. 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 Dec 1;94(11):2877–2882. doi: 10.1161/01.cir.94.11.2877. [DOI] [PubMed] [Google Scholar]
  24. Nwasokwa O. N., Weiss M., Gladstone C., Bodenheimer M. M. Higher prevalence and greater severity of coronary disease in short versus tall men referred for coronary arteriography. Am Heart J. 1997 Feb;133(2):147–152. doi: 10.1016/s0002-8703(97)70202-3. [DOI] [PubMed] [Google Scholar]
  25. Palmer J. R., Rosenberg L., Shapiro S. Stature and the risk of myocardial infarction in women. Am J Epidemiol. 1990 Jul;132(1):27–32. doi: 10.1093/oxfordjournals.aje.a115639. [DOI] [PubMed] [Google Scholar]
  26. Patel P., Mendall M. A., Khulusi S., Northfield T. C., Strachan D. P. Helicobacter pylori infection in childhood: risk factors and effect on growth. BMJ. 1994 Oct 29;309(6962):1119–1123. doi: 10.1136/bmj.309.6962.1119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Rich-Edwards J. W., Manson J. E., Stampfer M. J., Colditz G. A., Willett W. C., Rosner B., Speizer F. E., Hennekens C. H. Height and the risk of cardiovascular disease in women. Am J Epidemiol. 1995 Nov 1;142(9):909–917. doi: 10.1093/oxfordjournals.aje.a117738. [DOI] [PubMed] [Google Scholar]
  28. Ruggeri B. A., Klurfeld D. M., Kritchevsky D., Furlanetto R. W. Growth factor binding to 7,12-dimethylbenz(a)anthracene-induced mammary tumors from rats subject to chronic caloric restriction. Cancer Res. 1989 Aug 1;49(15):4135–4141. [PubMed] [Google Scholar]
  29. Smith G. D., Hart C., Blane D., Gillis C., Hawthorne V. Lifetime socioeconomic position and mortality: prospective observational study. BMJ. 1997 Feb 22;314(7080):547–552. doi: 10.1136/bmj.314.7080.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Smith G. D., Hart C., Blane D., Hole D. Adverse socioeconomic conditions in childhood and cause specific adult mortality: prospective observational study. BMJ. 1998 May 30;316(7145):1631–1635. doi: 10.1136/bmj.316.7145.1631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Smith G. D., Hart C., Watt G., Hole D., Hawthorne V. Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. J Epidemiol Community Health. 1998 Jun;52(6):399–405. doi: 10.1136/jech.52.6.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Smith G. D., Leon D., Shipley M. J., Rose G. Socioeconomic differentials in cancer among men. Int J Epidemiol. 1991 Jun;20(2):339–345. doi: 10.1093/ije/20.2.339. [DOI] [PubMed] [Google Scholar]
  33. Smith G. D., Shipley M., Leon D. A. Height and mortality from cancer among men: prospective observational study. BMJ. 1998 Nov 14;317(7169):1351–1352. doi: 10.1136/bmj.317.7169.1351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Strachan D. P. Ventilatory function, height, and mortality among lifelong non-smokers. J Epidemiol Community Health. 1992 Feb;46(1):66–70. doi: 10.1136/jech.46.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Walker M., Phillips A., Shaper A. G., Whincup P. Re: "Height and the risk of cardiovascular disease in women". Am J Epidemiol. 1996 Oct 1;144(7):708–709. doi: 10.1093/oxfordjournals.aje.a008986. [DOI] [PubMed] [Google Scholar]
  36. Walker M., Phillips A., Shaper A. G., Whincup P. Re: "Height and the risk of cardiovascular disease in women". Am J Epidemiol. 1996 Oct 1;144(7):708–709. doi: 10.1093/oxfordjournals.aje.a008986. [DOI] [PubMed] [Google Scholar]
  37. Walker M., Shaper A. G., Phillips A. N., Cook D. G. Short stature, lung function and risk of a heart attack. Int J Epidemiol. 1989 Sep;18(3):602–606. doi: 10.1093/ije/18.3.602. [DOI] [PubMed] [Google Scholar]
  38. Walker S. P., Rimm E. B., Ascherio A., Kawachi I., Stampfer M. J., Willett W. C. Body size and fat distribution as predictors of stroke among US men. Am J Epidemiol. 1996 Dec 15;144(12):1143–1150. doi: 10.1093/oxfordjournals.aje.a008892. [DOI] [PubMed] [Google Scholar]
  39. Wannamethee S. G., Whincup P. H., Shaper G., Walker M. Influence of fathers' social class on cardiovascular disease in middle-aged men. Lancet. 1996 Nov 9;348(9037):1259–1263. doi: 10.1016/S0140-6736(96)02465-8. [DOI] [PubMed] [Google Scholar]
  40. Yarnell J. W., Limb E. S., Layzell J. M., Baker I. A. Height: a risk marker for ischaemic heart disease: prospective results from the Caerphilly and Speedwell Heart Disease Studies. Eur Heart J. 1992 Dec;13(12):1602–1605. doi: 10.1093/oxfordjournals.eurheartj.a060111. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES