Components of height and blood pressure in childhood

Nolwenn Regnault, Ken P. Kleinman, Sheryl L. Rifas-Shiman, Claudia Langenberg, Steven E. Lipshultz, Matthew W. Gillman

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Background: In children being taller is associated with higher blood pressure (BP), but few studies have divided height into its components: trunk and leg length. We examined the associations of total height, trunk length and leg length with systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) at early childhood and midchildhood visits, as well as change between the two visits. Methods: We obtained five measures of SBP and DBP at the early childhood visit (N=1153, follow-up rate=54%) and at the mid-childhood visit (N=1086, follow-up rate=51%) respectively, in Project Viva, a US cohort study. We measured total height and sitting height (a measure of trunk length that includes head and neck) and calculated leg length as the difference between the two. Using mixed models, we adjusted the cross-sectional analyses for leg length when trunk length was the exposure of interest, and vice versa. We also adjusted for maternal race/ethnicity, child age, sex, overall adiposity and BP measurement conditions. Results: At the mid-childhood visit, total height was positively associated with SBP [0.34 (0.24; 0.45) mmHg/cm] but not with DBP [0.07 (-0.003; 0.15)]. In models examining trunk and leg length separately, each was positively associated with SBP [0.72 (0.52; 0.92) and 0.33 (0.16; 0.49) respectively]. In a fully adjusted model with both leg and trunk length, only trunk length remained associated with BP. For a given leg length, a 1-cm increment in trunk length was associated with a 0.63-mmHg (0.42; 0.83) higher SBP and a 0.17-mmHg (0.02; 0.31) higher DBP. For a given trunk length, however, the associations of leg length with SBP [0.13 (-0.03; 0.30)] and with DBP [0.002 (-0.11; 0.12)] were null. These patterns were similar at the early childhood visit. Conclusions: Children with greater trunk lengths have higher BPs, perhaps because of the additional pressure needed to overcome gravity to perfuse the brain.

Original languageEnglish (US)
Article numberdyt248
Pages (from-to)149-159
Number of pages11
JournalInternational journal of epidemiology
Issue number1
StatePublished - Feb 2014
Externally publishedYes


  • Blood pressure
  • Child
  • Leg length
  • Longitudinal studies
  • Trunk length

ASJC Scopus subject areas

  • Epidemiology


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