Association Between Family History and Coronary Heart Disease Death Across Long-Term Follow-Up in Men

Abstract

Background Family history of coronary heart disease (CHD) has been well studied as an independent risk factor for CHD events in the short term (<10 years). However, data are sparse on the association between family history and risk for CHD across long-term follow-up. Methods and Results We included 49 255 men from the Cooper Center Longitudinal Study. Premature family history of CHD was defined as the presence of angina, myocardial infarction, angioplasty, or bypass surgery in a relative <50 years of age. Cause-specific mortality was obtained from the National Death Index. The association between premature family history and cardiovascular disease (CVD) or CHD death was compared across 3 unique follow-up periods (0–10, >10–20, and >20 years). Lifetime risk was estimated by use of a modified survival analytic technique adjusted for competing risk with non-CVD death as the competing event. After 811 708 person-years of follow-up, there were 919 CHD deaths and 1456 CVD deaths. After adjustment for traditional risk factors, premature family history was associated with CHD mortality >10 to 20 years (1.59; 95% confidence interval, 1.14–2.22) and >20 years (1.43; 95% confidence interval, 1.05–1.95) with wider confidence intervals at 0 to 10 years (1.32; 95% confidence interval, 0.76–2.31). Similar findings were observed for CVD mortality. Compared with men without a family history of coronary artery disease, premature family history was associated with an ≈50% higher lifetime risk for both CHD and CVD mortality (13.7% versus 8.9% and 21% versus 14.1%, respectively). Conclusion Premature family history was associated with a persistent increase in both CHD and CVD mortality risk across long-term follow-up, resulting in significantly higher lifetime risk estimates.

Family history and body mass index predict perceived risks of diabetes and heart attack among community-dwelling Caucasian, Filipino, Korean, and Latino Americans—DiLH Survey

“…For example, individuals with a family history of diabetes [28] or heart attack personally experienced the stress of managing these serious illnesses [29,30] as well as the wide range of their complications. Although this survey included a large diverse sample of English, Spanish or Korean speaking adults, the findings are similar to previous study results that included only English speaking samples [28,31]. The relationship between BMI and increased perceived risk of diabetes and heart attack has led to the recent broad public campaigns against the obesity epidemic in the United States.…”

2016 European Guidelines on cardiovascular disease prevention in clinical practice

“…71 A positive family history of premature CV death is associated with an increased risk of early and lifetime CVD. 74 In the few studies that simultaneously assessed and reported the effects of family history and genetic scores, family history remained significantly associated with the incidence of CVD after adjusting for the genetic scores. 75,76 Limited data exist regarding the ability of family history to improve the prediction of CVD a Blood pressure <140/90 mmHg is the general target.…”

Genetic analysis of atherosclerosis identifies a major susceptibility locus in the major histocompatibility complex of mice

“…The important role of genetic factors in atherosclerosis has been clearly demonstrated in numerous studies, including prospective studies of twins, families and cohorts [2–4], and genome-wide association studies (GWAS) [5–7]. Apart from rare cases of Mendelian inheritance that are caused by missense or nonsense mutations with large effect, the vast majority of coronary heart disease is complex, probably involving many genes of small effect [8].…”