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

Objectives-Height is inversely associated with cardiovascular disease morta lity risk and has shown variable associations with cancer incidence and mor tality The interpretation of findings from previous studies has been constr ained 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. Detail ed assessments of cardiovascular disease risk factors, morbidity and socioe conomic circumstances were made at baseline. Main outcome measures-Deaths d uring 20 years of follow up classified into specific causes. Results-Over the follow up period 3347 men and 2638 women died. Height is i nversely associated with all cause, coronary heart disease, stroke, and res piratory disease mortality among men and women. Adjustment for socioeconomi c position and cardiovascular risk factors had little influence on these as sociations, Height is strongly associated with forced expiratory volume in one second (FEV,) and adjustment for FEV, considerably attenuated the assoc iation between height and cardiorespiratory mortality. Smoking related canc er mortality is not associated with height. The risk of deaths from cancer unrelated to smoking tended to increase with height, particularly for haema topoietic, colorectal and prostate cancers. Stomach cancer mortality was in verseIy associated with height. Adjustment for socioeconomic position had l ittle influence on these associations. Conclusion-Height serves partly as an indicator of socioeconomic circumstan ces and nutritional status in childhood and this may underlie the inverse a ssociations between height and adulthood cardiorespiratory mortality. Much of the association between height and cardiorespiratory mortality was accou nted for by lung function, which is also partly determined by exposures act ing in childhood. The inverse association between height and stomach cancer mortality probably reflects Helicobacter pylori infection in childhood res ulting in-or being associated with-shorter height. The positive association s between height and several cancers unrelated to smoking could reflect the influence of calorie intake during childhood on the risk of these cancers.