Family history of cardiovascular disease and risk of premature coronary heart disease: A matched case-control study

Abstract

Background: Self-reported family history of cardiovascular disease (CVD) is an independent risk factor for future coronary heart disease (CHD) events. However, inclusion of family history of CVD in the traditional risk scores failed to improve risk prediction of CHD. It is proposed that family history of CVD may substantially increase the risk of CHD among younger individuals. Methods: We conducted a matched case-control study with 170 hospital-based premature CHD patients (<55 years in men and <65 years in women) from a tertiary care centre in Thiruvananthapuram, Kerala and age and sex matched community-based controls in 1:1 ratio. Conditional logistic regression analysis was conducted to assess the independent association of family history of cardiovascular disease (CVD) and premature CHD. We estimated McNemar's odds ratios and their 95 percent confidence intervals. Results: The prevalence of any family history of CVD and CHD in the control population was 24% and 21%, respectively. The family history of CVD was independently associated with premature CHD (odds ratio (OR) = 9.0; 95% confidence interval (CI) 4.7–17.3). There was a dose-response relationship between family history and premature CHD as the risk increased linearly with increase in number of affected family members. Conclusions: Family history of CVD is an independent risk factor for premature CHD. The risk of premature CHD increases linearly with increase in number of affected family members. Collecting family history beyond parental history of CVD is important for risk stratification. Targeting young individuals with family history of CVD for intensive risk reduction interventions may help to prevent future events.

Arterial injury mechanism of homocysteine after PCI in patients with premature coronary heart disease

“…Unlike controllable risk factors, such as diabetes history, a family history of CHD is a risk factor that cannot be prevented. In a previous study, approximately one-quarter of the population with a family history of CHD was at high risk of CHD, requiring premature intervention to prevent the occurrence of PCHD [38]. A study based on a community population in the United States showed that the prevalence rate of PCHD in young people with a positive family history of CHD was approximately 75% [39].…”

Efficacy of a family-based cardiovascular risk reduction intervention in individuals with a family history of premature coronary heart disease in India (PROLIFIC): an open-label, single-centre, cluster randomised controlled trial

“…However, individuals with a family history of the disease comprise a large group (at least 24% of the total adult population in India). 12 Hence, our approach could have substantial public health benefits by preventing future cardiovascular events if applied at the population level. Similar family-based studies with population-wide coverage will help us to understand the effect of this intervention model at the population level.…”

“…9,10 A family history of premature coronary heart disease is associated with a 1•5-7 times higher risk of future cardiovascular events. [11][12][13] Although the excess risk was initially thought to be due to genetic factors, substantial evidence shows that it is due to shared environment, and similarity in behaviour and belief systems within families. 14 Furthermore, modifiable traditional risk factors jointly mediate a substantial portion of the increased risk of the disease conferred by a positive family history.…”