Short stature and prognosis of coronary heart disease in women


: Professor Kristina Orth-Gomér, Karolinska Institutet, Department of Public Health Sciences, Division of Preventive Medicine, Novum Plan 7, Post fack 30, S-141 57 Huddinge, Sweden (fax: +46 8585 850 20; e-mail:


Objectives.  To investigate the effect of short stature on prognosis following an acute event of coronary heart disease (CHD) in women.

Setting.  All women who were hospitalized for an acute event of CHD in any of the 10 cardiology clinics in greater Stockholm were investigated for the first time in the Stockholm Female Coronary Risk Study between 1991 and 1994, and were followed until August 1997 for recurrent coronary events.

Design.  A follow-up study of women with either acute myocardial infarction (AMI) or unstable angina pectoris. Median follow-up period was 4.8 years.

Subjects.  A total of 292 Swedish women, aged 65 years or younger.

Main outcome measures.  Recurrent AMI, death from CHD or revascularization procedure (percutaneous transluminal coronary angioplasty and coronary artery bypass grafting).

Results.  Independent of the confounding effects of other risk factors of clinical importance for CHD (age, socioeconomic status, menopausal status, index event, congestive heart failure, angina severity, diabetes, hypertension, smoking, triglycerides and HDL cholesterol), the shortest 25% of women (< 160 cm) had a 2.1-fold (95% CI = 1.0–4.4) increased rate of developing adverse cardiac events (cardiovascular death, recurrent AMI or revascularization procedure) compared with the tallest 25% (> 165 cm). In addition, an increased rate was observed for each 10 cm difference in height (hazard ratio = 1.7, 95% CI = 1.4–2.7). Similar results were observed when analysing each outcome separately.

Conclusions.  These data indicate that short stature is a strong predictor of poor prognosis after an acute coronary event in women, independent of socioeconomic status and other risk factors for CHD.