A 1977 song by Randy Newman started off with these lyrics: “Short people got no reason to live.” Although Newman said he meant it as a funny, satirical song about prejudice, many took it as a non-humorous jab at short folks. New research indicating shorter-than-average people could be stuck with more heart disease due to their size could make them feel singled out unfairly once again — this time, by biology.
But does being short really doom you to a high risk of heart disease? The short answer (pun intended) is, probably not.
It’s true links between height and heart risks have been noted in some studies. But there’s also evidence these associations don’t hold up for everybody of short stature — indicating that diet and other factors likely play a far more important role in cardiovascular health than how tall or short you are.
For the latest height study, a group of international researchers, headed by University of Leicester cardiologist Sir Nilesh Samani, gathered genetic data from around 200,000 men and women around the world. They found that, on average, a person about five feet tall had a 30 percent greater chance of developing heart disease than a person who was 5 feet 6 inches tall. The study concluded each extra 2.5 inches of height resulted in a 13.5 percent reduction in heart disease risk.
Looking for an explanation, the research team studied genetic variations linked to short stature that could result in an elevated risk of heart disease. Although there are about 180 gene variants that control height, Samani and his colleagues found only one clear way these genetic variants linked to short stature might increase heart disease risk. The genetic variations raise levels of LDL (the artery clogging “bad” cholesterol) and triglycerides (blood fats associated with heart disease risk) — but only slightly.
These small elevations in cholesterol and triglycerides hardly seem a possible explanation for an increased heart disease risk, a fact the researchers noted in their study. They proposed some other as-yet-not-understood role height genes might play in causing more cardiovascular disease, according to Sekar Kathiresan, MD, director of preventive cardiology at Massachusetts General Hospital, a co-author of the study.
However, not everyone is convinced there is a firm link between short stature and heart risk at all — and certainly not for all short people.
For example, southern Europeans tend to have short stature and yet have low rates of cardiac death. And citizens of Portugal and Spain, who are five inches shorter than people in northern Europe on average, are about two times less likely to have fatal cardiovascular disease than the much taller natives of Norway and Sweden.
What’s more, natives of Japan's Okinawa islands are some of the healthiest people on the planet — and also some of the shortest. The average height of an Okinawan man is only 4’ 9.” Yet Okinawans tend to have extremely long and healthy lifespans with the lowest rates of cancer and heart disease in the world. In fact, Okinawans are 7 times more likely to live to be100 or older than people in other areas.
Some researchers suggest that when studies do reveal more heart disease among shorter people, it could be the result of factors like childhood illness and poor environmental conditions that resulted in shorter statue and could have impacted the cardiovascular system. They also cite the influence of unhealthy diets, especially in industrialized nations.
Research into the short Okinawans backs up the association between food, lifestyle and protection from heart disease. Okinawans typically eat a low-calorie diet with whole grains, fish, and lots of vegetables. They regularly drink tea, which is loaded with antioxidants, too. They also are active and keep their weight on the slim side. But when Okinawans move away to the U.S. or to mainland Japan, their risk of heart disease goes up and life expectancy goes down, most likely due to a change in diet and lifestyle. Clearly, they aren’t suddenly developing heart disease because they are short.
The bottom line, whether you are short, tall, or in between, is simple: You can take control of your lifestyle and lower your risk of cardiovascular disease by watching your weight, exercising regularly, keeping stress under control, stopping smoking, and eating a heart-healthy diet. The National Heart, Lung and Blood Institute offers more information on how to prevent cardiovascular disease.
July 27, 2015
Christopher Nystuen, MD, MBA