TY - JOUR

T1 - Loss of height predicts total and cardiovascular mortality

T2 - a cohort study of northern European women

AU - Klingberg, Sofia

AU - Mehlig, Kirsten

AU - Dangol, Rojina

AU - Bjorkelund, Cecilia

AU - Heitmann, Berit Lilienthal

AU - Lissner, Lauren

PY - 2021

Y1 - 2021

N2 - 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. Setting Sweden and Denmark. 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.

AB - 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. Setting Sweden and Denmark. 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.

KW - epidemiology

KW - preventive medicine

KW - public health

KW - cardiology

KW - BODY-MASS INDEX

KW - LONGITUDINAL DATA

KW - HIP FRACTURE

KW - OLDER WOMEN

KW - HEALTH

KW - RISK

KW - MEN

KW - FRAILTY

KW - WEIGHT

KW - ADULTS

U2 - 10.1136/bmjopen-2021-049122

DO - 10.1136/bmjopen-2021-049122

M3 - Journal article

C2 - 34373307

VL - 11

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 8

M1 - 049122

ER -