标题：Adult Socioeconomic Position and the Association Between Height and Coronary Heart Disease Mortality: Findings From 33 Years of Follow-Up in the Whitehall Study
摘要：In the Whitehall Study, which followed 17139 male civil servants over 33 years, the association between tall stature and coronary heart disease (CHD) mortality differed between employment grades. In men without CHD at study entry, the hazard ratio per 15-cm increase in height was 0.77 (95% confidence interval [CI]=0.69, 0.85; P <0.001) for the highest grades, but 0.84 (95% CI=0.69, 1.03; P =.10) for middle and 0.95 (95% CI = 0.75, 1.20; P = .65) for low grades, suggesting that childhood and adult social conditions may interact in their influence on coronary risk. Early case-control 1– 3 and cohort studies 4– 7 reported an inverse association between adult height and coronary heart disease (CHD). Supporting evidence is now available from more recent cohort studies of men, 5, 8– 15 women, 16 or both. 17– 21 Studies also have reported an association with cerebrovascular disease but these findings have been somewhat discrepant. 14, 20– 22 The few studies to explore the influence of height on mortality in participants with prevalent CHD have yielded conflicting results for prognosis after myocardial infarction. 23– 26 Atherosclerosis and cardiovascular risk start in early life, 27 and growth-limiting factors have been suggested to contribute to the origins of these risks through early biological changes in the developing vasculature. 28– 30 But height is also an indicator of childhood social conditions, 30– 32 and shorter people may have greater cardiovascular vulnerability through continuing social disadvantage. 33 Earlier analyses suggested weaker height-related effects with longer follow-up, possibly attributable to selective premature mortality of ill participants with height reduction before study entry. 34 We investigated whether the association between height and cardiovascular mortality differs by adult socioeconomic circumstances and compared associations by follow-up period.
