Abstract
Background: A number of cross-sectional studies have reported shorter height as a risk factor for peripheral artery disease (PAD) defined by low ABI. People of shorter stature may have a naturally lower ABI stemming from a relatively lower ankle blood pressure, as function of the shorter distance from the heart to the distal leg arteries. If shorter height is related to PAD, height should also be associated with clinical PAD. We aimed to investigate the association of height with clinical PAD and critical limb ischemia (CLI) in a prospective cohort analysis. Methods: Using data from the ARIC Study, we investigated the association of height with development of PAD and CLI, defined based on ICD-9 codes, for the 14,668 participants at Visit 1 without prevalent PAD/CLI over a median follow-up time of 25.9 years. We modeled risk for PAD and CLI over time using Cox proportional hazards regression. Results: 6,652 (45.4%) participants were men, with a mean age of 55 (SD 6) years old, compared to 54 (SD 6) years old in women. 1,460 (22%) men and 2,321 (29%) women were African American. Men tended to be taller and have a higher weight compared to women. Within each sex, there were no significant differences by quartile of height in terms of demographic factors or clinical comorbidities. For men in height quartile 2 compared to quartile 1, there was a decreased risk of PAD in unadjusted analysis (HR=0.69; 95% CI 0.51-0.94). However, this HR was no longer significant after full adjustment (Table 1). In women, the risk of CLI was higher in the fourth quartile of height compared to quartile 1 after adjustment for demographic factors (HR=1.69; 95% CI: 1.00-2.84). However this HR also became non-significant after full adjustment. For both genders, the HR of either PAD or CLI per one SD increase in height was not significant. Conclusions: In contrast to previous cross-sectional studies which showed and association between shorter height and PAD based on ABI, our prospective study showed null associations between height and clinical PAD.
Published Version
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