Stroke patients' knowledge about cardiovascular family history - the Norwegian Stroke in the Young Study (NOR-SYS)
Halvor Øygarden1,2, Annette Fromm3,4, Kristin Modalsli Sand5
1Department of Clinical Medicine, University of Bergen, Bergen, Norway. havy@helse-bergen.no.
Insights
Family history (FH) significantly impacts cardiovascular disease risk. This study found young and middle-aged stroke patients have substantial cardiovascular FH, with women reporting more knowledge than men.
Area of Science:
- Neurology
- Cardiology
- Genetics
Background:
- Family history (FH) is a known risk factor for cardiovascular disease (CVD), including coronary artery disease (CAD), but its association with stroke risk is less understood.
- This study focuses on young and middle-aged ischemic stroke patients, investigating their awareness of family history for stroke, CAD, and peripheral artery disease (PAD).
- A particular emphasis is placed on identifying potential sex differences in this awareness.
Purpose of the Study:
- To assess the knowledge of young and middle-aged ischemic stroke patients regarding their family history of stroke, CAD, and PAD.
- To explore potential sex-based differences in reporting and knowledge of cardiovascular family history.
- To determine which cardiovascular conditions patients have the most detailed family history knowledge about.
Main Methods:
- Prospective inclusion of ischemic stroke patients aged 15-60 years in the Norwegian Stroke in the Young Study (NOR-SYS) from September 2010 to February 2014.
- Standardized face-to-face interviews to assess family history of stroke, CAD, and PAD in first- and second-degree relatives, including a 'don't know' option.
- Statistical analyses included McNemar's test for paired proportions and multiple logistic regression to evaluate the influence of patient sex on FH reporting, adjusting for confounders.
Main Results:
- Out of 257 included patients (mean age 49.5 years, 68.1% males), 59% reported a cardiovascular FH.
- Patients reported 'don't know' for maternal grandmothers significantly less often than paternal grandmothers (32.4% vs. 45.5%, p < 0.001).
- Female patients were more likely to report a positive cardiovascular FH (OR: 3.4; 95% CI: 1.5 to 7.7; p = 0.004) and reported 'don't know' less frequently than males. Knowledge was more detailed for CAD than for stroke in parents and siblings.
Conclusions:
- Young and middle-aged stroke patients exhibit a considerable burden of cardiovascular family history.
- Female patients demonstrate greater awareness and reporting of cardiovascular FH compared to male patients.
- Knowledge regarding family history is more comprehensive for coronary artery disease than for stroke, and appears to be influenced by the sex of the relative.
Background:
Family history (FH) is a risk factor for cardiovascular disease, especially coronary artery disease (CAD). The impact on risk of stroke is less clear. This study investigated young and middle-aged ischemic stroke patients' knowledge on FH of stroke, CAD, and peripheral artery disease (PAD) with a special regard to sex differences.
Methods:
From September 2010 to February 2014, all ischemic stroke patients aged 15-60 years were prospectively included in the Norwegian Stroke in the Young Study (NOR-SYS). FH of stroke, CAD and PAD in offspring, siblings, parents, and grandparents was assessed using a standardized face-to-face interview. In addition to 'yes' and 'no', the optional reply 'don't know' was included to improve accuracy. McNemar's test was used to compare paired proportions, i.e. FH in male vs. female relatives. Multiple logistic regression analyses were used to test the influence of patient sex on FH reporting and to adjust for possible confounding factors.
Results:
Altogether 257 patients were included. Mean age was 49.5 years and 68.1% were males. FH of cardiovascular disease was reported by 59% of patients. When asked about FH of stroke, 48 (18.7%) and 46 (17.9%) patients reported yes, whereas 17 (6.6%) and 9 (3.5%) reported 'don't know' regarding father and mother respectively, similarly patients reported 'don't know' regarding 117 (45.5%) paternal vs. 83 (32.4%) maternal grandmothers (p < 0.001). Female patients reported less 'don't know' and were more likely to report a positive cardiovascular FH than males (OR: 3.4; 95% CI: 1.5 to 7.7; p = 0.004). Patients had more detailed knowledge about CAD than stroke in fathers (p < 0.001), mothers (p < 0.001) and siblings (p = 0.01).
Conclusions:
Young and middle-aged stroke patients reported a high FH burden of cardiovascular disease. Females are more likely to report a positive FH than males. Detailed knowledge on FH was best for CAD. Our results suggest sex has a big impact on FH knowledge. Females have more knowledge of FH than males and knowledge is better for relatives with a female than male linkage.
Clinical Trial Registration:
http://www.clinicaltrials.gov , unique identifier: NCT01597453 .
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