Associations between height and blood pressure in the United States population

Abstract

The mechanisms linking short stature with an increase in cardiovascular and cerebrovascular disease risk remain elusive. This study tested the hypothesis that significant associations are present between height and blood pressure in a representative sample of the US adult population.Participants were 12,988 men and women from a multiethnic sample (age ≥ 18 years) evaluated in the 1999 to 2006 National Health and Nutrition Examination Survey who were not taking antihypertensive medications and who had complete height, weight, % body fat, and systolic and diastolic arterial blood pressure (SBP and DBP) measurements; mean arterial blood pressure and pulse pressure (MBP and PP) were calculated. Multiple regression models for men and women were developed with each blood pressure as dependent variable and height, age, race/ethnicity, body mass index, % body fat, socioeconomic status, activity level, and smoking history as potential independent variables.Greater height was associated with significantly lower SBP and PP, and higher DBP (all P < .001) in combined race/ethnic-sex group models beginning in the 4th decade. Predicted blood pressure differences between people who are short and tall increased thereafter with greater age except for MBP. Socioeconomic status, activity level, and smoking history did not consistently contribute to blood pressure prediction models.Height-associated blood pressure effects were present in US adults who appeared in the 4th decade and increased in magnitude with greater age thereafter. These observations, in the largest and most diverse population sample evaluated to date, provide support for postulated mechanisms linking adult stature with cardiovascular and cerebrovascular disease risk.

Figure 1

Predicted brachial artery blood pressure differences (ΔBP, short–tall BP) between the 5th and 95th height percentiles for a representative adult male (BMI, 25 kg/m²; % body fat, 25) and female (BMI, 25 kg/m²; % body fat, 40) at 3 ages. A race × height interaction was present for female PP and the predicted ΔBP was derived using values for non-Hispanic White. Variations in predicted ΔBP values for women of other race/ethnic groups are given in Section 3. BMI = body mass index, BP = blood pressure, DBP = diastolic blood pressure, MBP = mean arterial blood pressure, PP = pulse pressure, SBP = systolic blood pressure.

Figure 2

Predicted brachial artery blood pressure differences (ΔBP, short–tall BP) between the 5th and 95th percentiles for a representative male (age, 50 years; % body fat, 25) and female (age, 50 years; % body fat, 40) at 3 levels of BMI. The predicted values were derived using non-Hispanic White. Other race/ethnic groups for men and women displayed the same differences in blood pressure readings with the exception of female PP, although the same trend occurred. BMI = body mass index, BP = blood pressure, DBP = diastolic blood pressure, MBP = mean arterial blood pressure, PP = pulse pressure, SBP = systolic blood pressure.