Short stature and hypertension in the city of Rio de Janeiro, Brazil

Objective: Stature is a powerful indicator of poor nutrition early in life in nations where undernutrition is a public health problem. Hypertension in adults has been associated with factors present early in life such as low birth weight. We tested the hypothesis that short stature is associated with hypertension among adults. Design and setting: A household survey of representative adults in Rio de Janeiro city, Brazil was carried out in 1996. Subjects: Blood pressure and anthropometric measures were collected from 2802 adults in their own households. Prevalence estimates and modelling incorporated the sample design and weights. Results: Age-adjusted prevalence of hypertension for both sexes was lower in the third quartile of stature distribution. In women, but not in men, the odds ratio comparing the first quartile of stature with the fourth quartile was statistically significant with an odds ratio of 1.68 (95% CI 1.02-2.76). Adjusting for known risk factors for hypertension such as age, income, smoking, sodium and alcohol intake and race, the association among women, comparing the first with the fourth quartile for stature, was 1.84 (95% CI 1.03-3.30). With further adjustment for residual of weight on height the ratio reduced to 1.76 (95% CI 0.97-3.19, P value of trend = 0.03). Systolic blood pressure showed a U-shaped association with quartiles of stature, mainly among women, with a beta-coefficient significantly lower at the third quartile. Conclusions: This association of stature with hypertension supports the theory of an important ontogenetic dependence of adult blood pressure, at least among women.