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Additive association of blood pressure and short stature with stroke incidence in 450,000 Japanese adults: the Shizuoka study

Hypertension Research (2024)Cite this article

Abstract

Short stature was suggested to be a risk factor for cardiovascular events. Because short stature increases central blood pressure, this study aimed to investigate a longitudinal association between short stature, blood pressure, and incidence of cardiovascular disease by the analysis of insurance-based real-world dataset. We analyzed data from 463,844 adults aged 40 or older with a mean age of 66.7 enrolled in National Health Insurance, excluding individuals who experienced a stroke or myocardial infarction, or required long-term care. Data from annual health checkups were used to obtain baseline clinical information. Comorbidities and incidences of stroke and myocardial infarction were obtained from the insurance data. During a 5.5-year follow-up period, we observed 11,027 cases of stroke. Adults of a short stature exhibited a higher incidence rate in both men (≤155 cm: 99.7, >175 cm: 24.4) and women (≤140 cm: 85.9, >160 cm: 13.7). Although those in the short stature group had higher blood pressure, and often took antihypertensive drugs, the inverse association between height and stroke incidence was independent of these factors (hazard ratio for 5 cm shorter in height; men: 1.06 [1.03–1.09], women: 1.11 [1.06–1.13]). Short stature and blood pressure showed additive association with stoke incidence (log-rank p < 0.001). No significant association was observed with myocardial infarction (men: 1.01 [0.95–1.06], women: 1.06 [0.98–1.14]). In a longitudinal analysis of a large general Japanese population, short stature was linked to an increased risk of stroke in both genders in any blood pressure range.

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Acknowledgements

We thank the Shizuoka Prefectural Government, 35 city and town offices in the Shizuoka Prefecture, and the Shizuoka Federation of National Health Insurance Organizations for their help in constructing the SKDB dataset. We also thank the editors of Crimson Interactive Pvt. Ltd. for their assistance in the preparation of this manuscript.

Funding

This study was supported by a public health research grant from Shizuoka Prefecture.

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Authors and Affiliations

  1. Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan

    Yasuharu Tabara, Aya Shoji-Asahina, Aya Ogawa & Yoko Sato

  2. Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan

    Yasuharu Tabara

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Correspondence to Yasuharu Tabara.

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Tabara, Y., Shoji-Asahina, A., Ogawa, A. et al. Additive association of blood pressure and short stature with stroke incidence in 450,000 Japanese adults: the Shizuoka study. Hypertens Res (2024). https://doi.org/10.1038/s41440-024-01702-x

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