Short people got no reason… to worry about this study

As a short person growing up in a short family in the 1970s I remember being a little put off by the Randy Newman song Short People. Here’s a little taste if you don’t recall:

Short people got no reason
To live

They got little hands
Little eyes
They walk around
Tellin’ great big lies
They got little noses
And tiny little teeth
They wear platform shoes
On their nasty little feet

There were multiple parodies of it. The lyrics to one (Tall People) include:

They bump their heads
on a sign or a door
They have to shop
at the too tall store
They got big SUV’s
That go zoom zoom zoom
They got loud voices
Goin’ boom boom boom
They die much earlier (emphasis mine)
they can’t accelerate
They’re gonna bump their head every time

Some tall person in Finland must have read those lyrics and decided to conduct a systematic review and meta-analysis to reinforce the bias against short people. After analyzing 52 studies of various types the researchers concluded that being relatively short (compared to the study population) is associated with a 50 percent higher risk of cornorary heart disease morbidity and mortality.

The researchers really have no idea why this conclusion holds or what to do about it. Here are the rather inane implications for practice and research:

Implications for practice

Height is used to calculate body mass index (BMI), which is a widely used quantity risk of CHD. The value of BMI has been recently questioned by reports showing that BMI may not associate with the severity of CHD in angina patients with chronic kidney disease or may even be inversely associated. This has been discussed as the obesity paradox. The results of this meta-analysis suggest that height may be considered as a possible independent factor to be used in CHD risk calculations.
Implications for research

It would be interesting to explore—e.g. in autopsy series—the possibility that short stature is connected with the risk of CHD and MI through the effect of smaller coronary artery diameter, and that smaller coronary arteries may be occluded earlier in life under similar risk conditions. Recent findings on the genetic background of body height74 suggest that inherited factors rather than speculative early-life poor nutrition or birth weight may explain the association between small stature and later-life increased risk for CHD events.

Count me out of the autopsy study.

June 10, 2010

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