Influence of body height on pulsatile arterial hemodynamic data.
OBJECTIVE
This study sought to present evidence that short stature is a hemodynamic liability, which could explain in part the inverse relation between body height and cardiovascular risk.


BACKGROUND
Other explanations for the association of short stature with increased cardiovascular risk include advancing age, reduced pulmonary function, genetic factors, poor childhood nutrition and small-caliber coronary arteries. This study adds another factor-the physiologic effects of reduced body height on the arterial tree, which increase left ventricular work and jeopardize myocardial perfusion.


METHODS
Four hundred two subjects were studied: 149 with end-stage renal disease and 253 with normal renal function. Measurements included blood pressure, body height, cardiac cycle length, carotid to femoral artery pulse wave velocity, carotid artery pulse waves (by applanation tonometry) and the arrival time of reflected waves. Calculations included the carotid augmentation index, carotid artery compliance and the diastolic to systolic pressure-time ratio (an index of myocardial supply and demand).


RESULTS
On linear and stepwise multiple regression, body height correlated with all variables except mean blood pressure.


CONCLUSIONS
The early systolic arrival of reflected waves in short people in this group acts to stiffen the aorta and increase the pulsatile effort of the left ventricle, even at the same mean blood pressures. Short stature also induces a faster heart rate, which increases cardiac minute work and shorten diastole. Stiffening lowers the aortic diastolic pressure and, coupled with a shortened diastole, could adversely influence myocardial supply. Although indirect, this evidence supports a physiologic hypothesis for the body height-cardiovascular risk association.
Smulyan
H
H
Department of Medicine, State University of New York Health Science Center, Syracuse 13210, USA. SmulyanH@mailbox.hscsyr.edu
Marchais
S J
SJ
Pannier
B
B
Guerin
A P
AP
Safar
M E
ME
London
G M
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology; D001827:Body Height; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D012044:Regression Analysis; D012307:Risk Factors