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Sibling rank and sibling number in relation to cardiovascular disease and mortality risk: a nationwide cohort study

Peter M Nilsson1, Jan Sundquist2, Kristina Sundquist2

  • 1Clinical Sciences, Lund University, Malmö, Sweden Peter.Nilsson@med.lu.se.

BMJ Open
|May 26, 2021
PubMed

Insights

Sibling number impacts cardiovascular disease risk. More siblings may increase cardiovascular events, but also lower total mortality risk for women, while birth order influences non-fatal event risk.

Area of Science:

  • Epidemiology
  • Public Health
  • Cardiovascular Medicine

Background:

  • Sibling number and birth order are potential factors influencing cardiovascular disease (CVD) risk and mortality.
  • Previous research primarily utilized fatal events for risk prediction, necessitating the inclusion of non-fatal events.

Purpose of the Study:

  • To investigate the association between sibling number, birth order, and the risk of both fatal and non-fatal cardiovascular and coronary events.
  • To utilize fully adjusted models incorporating non-fatal events for enhanced risk prediction.

Main Methods:

  • Utilized data from the Swedish Multiple-Generation Register, including 1.36 million men and 1.32 million women (born 1932-1960).
  • Follow-up occurred from 1990 to 2015, with participants aged 30-58 at baseline and a mean follow-up age of 67.
  • Fatal and non-fatal cardiovascular events were ascertained through national registers.

Main Results:

  • Men with 1-2 siblings showed lower CVD risk; those with four or more siblings had higher risk compared to men with no siblings.
  • Men with more than one sibling had lower total mortality risk, but three or more siblings increased coronary event risk.
  • Women with three or more siblings faced increased CVD risk, while two or more siblings raised coronary event risk. Women with one or more siblings had lower total mortality risk.

Conclusions:

  • Being the firstborn is linked to a reduced risk of non-fatal cardiovascular and coronary events in both men and women.
  • Further research is recommended to explore the underlying biological and sociocultural mechanisms influencing these associations.
Abstract

Keywords:
epidemiologyreproductive medicinesocial medicine

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