Influence of short stature on the change in pulse pressure, systolic and diastolic blood pressure from age 36 to 53 years: an analysis using multilevel models
Background Previous cross-sectional analyses of this cohort have shown that short height and leg length are associated with higher pulse pressure and systolic blood pressure in middle age. It is unclear how these adult measures of childhood growth influence the change in blood pressure as it increases with age. Methods Multilevel models were fitted to investigate associations between components of height and the change in blood pressure between 36, 43, and 53 years in a prospective national cohort of 1472 men and 1563 women followed-up since birth in 1946. Results Shorter height and leg length, but not trunk length, were associated with higher blood pressure, similarly in men and women. Longitudinal analyses showed that the effects of both height and leg length on pulse pressure and systolic blood pressure became significantly stronger with age. For example, the change in systolic blood pressure was found to be � 0.021 mm Hg (95% confidence interval � 0.029 to � 0.013) per year lower for every centimetre increase in leg length (P � 0.001). In other words, the increase in systolic blood pressure over a 10 year period of a participant whose legs were 10 centimetres shorter was 2.1 mm Hg higher (P � 0.001), compared with a taller participant. Associations were independent of a number of potential confounders. Conclusions These results support the hypothesis that short people may be more susceptible to the effects of ageing on the arterial tree. Childhood growth may contribute to the tracking of cardiovascular risk throughout life.