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Cardiovascular Risk Factors Among First-Degree Relatives of Patients with Premature Cardiovascular Disease in Malta.
Justin Lee Mifsud1,2, Joseph Galea2
1Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta.
Insights
First-degree relatives of individuals with premature atherosclerotic cardiovascular disease (ASCVD) have a high prevalence of risk factors like obesity and hypertension. Early screening and intervention are crucial for this high-risk group.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- A family history of premature atherosclerotic cardiovascular disease (ASCVD) is a significant risk factor for developing the condition.
- Understanding the prevalence of ASCVD risk factors in asymptomatic first-degree relatives is crucial for targeted prevention strategies.
Purpose of the Study:
- To evaluate the prevalence of ASCVD risk factors among asymptomatic Maltese adults with a family history of premature ASCVD.
- To compare the risk factor profile of these individuals with the general population.
Main Methods:
- Recruitment through cardiac rehabilitation areas, pharmacies, social media, and referrals from medical professionals.
- Enrollment of eligible first-degree relatives into a preventive cardiology lifestyle intervention program.
- Comparison of collected data with the general population's risk profiles.
Main Results:
- A high prevalence of suboptimal risk factors was observed: 60% had high total cholesterol, 54% had high LDL-cholesterol, 70.5% were overweight/obese, 34.8% had hypertension, 56.2% had poor Mediterranean diet adherence, 62% were underactive, and 25.8% were smokers.
- First-degree relatives showed significantly higher rates of underactive lifestyle (p = 0.00016), high BMI (p = 0.006), and elevated systolic blood pressure (p = 0.001) compared to the general population.
- 30% of first-degree relatives were diagnosed with metabolic syndrome.
Conclusions:
- Asymptomatic first-degree relatives of patients with premature ASCVD exhibit substantial prevalence of cardiovascular risk factors, including underactive lifestyle, hypertension, and obesity.
- There is a need for enhanced screening and early intervention strategies to mitigate ASCVD risk in this population.
- Proactive management of modifiable risk factors is essential for preventing premature cardiovascular events in genetically predisposed individuals.
Purpose:
A family history of premature atherosclerotic cardiovascular disease (ASCVD) confers a greater risk of developing ASCVD. However, the prevalence of ASCVD risk factors among asymptomatic Maltese adults with parental or fraternal history of premature ASCVD is unknown. The study aimed to evaluate and compare their risk with the general population.
Patients And Methods:
Posters to market the project were distributed in cardiac rehabilitation areas. Patients with premature cardiovascular disease facilitated recruitment by informing their relatives about the project. Medical doctors and cardiac rehabilitation nurses referred first-degree relatives. Posters were put up in community pharmacies, and an explanatory video clip was shared on social media for interested individuals to contact researchers. Those eligible were enrolled in a preventive cardiology lifestyle intervention. Their data were compared with the risk in the general population.
Results:
Many first-degree relatives had a suboptimal risk profile, with 60% (N = 89) having a total cholesterol level of >5.0 mmol/L; 54% having a low-density lipoprotein-cholesterol level of >3 mmol/L; 70.5% being overweight/obese, with 62% having a waist circumference greater than the recommended values; 34.8% having hypertension; 56.2% being inadequately adherent to the Mediterranean diet; 62% being underactive, with 18% being sedentary; and 25.8% being smokers. First-degree relatives had significantly higher proportions of underactive lifestyle (p = 0.00016), high body mass index (>25kg/m2) (p = 0.006), and systolic blood pressure (p = 0.001) than the general population, with 30% having metabolic syndrome.
Conclusion:
This study determined the prevalence of lifestyle, biochemical, physiological, and anthropometric cardiovascular risk factors among asymptomatic first-degree relatives of Maltese patients with premature ASCVD. First-degree relatives had considerable prevalences of an underactive lifestyle, hypertension, and obesity, suggesting better screening and early risk factor intervention are needed to modify their risk of ASCVD.
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