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Is a family history of coronary heart disease an independent coronary risk factor?
Insights
A family history of heart disease doesn't appear to be an independent risk factor. However, families may share susceptibility to common risk factors like smoking and high cholesterol.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Family history is a recognized risk factor for coronary heart disease (CHD).
- Understanding the independent contribution of family history is crucial for risk stratification.
Purpose of the Study:
- To evaluate the significance of a positive family history as an independent risk factor for coronary heart disease (CHD).
Main Methods:
- A case history study involving 792 male patients under 60 who survived a first myocardial infarction or unstable angina.
- Categorized patients based on family history: positive, negative, or uncertain.
- Analyzed the prevalence of primary CHD risk factors (smoking, hypertension, hypercholesterolaemia) in relation to family history.
Main Results:
- No significant difference in primary risk factors between patients with and without a positive family history.
- Patients with a positive family history of premature CHD were significantly younger.
- Limited evidence supports family history as an independent CHD risk factor.
Conclusions:
- A positive family history may not be an independent predictor of coronary heart disease.
- Familial aggregation of susceptibility to primary risk factors (smoking, hypertension, hyperlipidaemia) might explain observed patterns.
Abstract:
The importance of a positive family history as a primary risk factor for coronary heart disease was examined in a case history study. Of 792 consecutive male patients aged under 60 years who survived a first episode of unstable angina or myocardial infarction, 326 had a negative family history, 298 had a positive history, and in 168 a family history could not be established with certainty. There was no significant difference in the distribution of the three primary coronary risk factors--cigarette smoking, hypertension, and hypercholesterolaemia--between those with and those without a positive family history. The 133 subjects with a positive family history of premature coronary heart disease (occurrence in near relatives under 60 years) were significantly younger than those with a negative family history. It is concluded that there is little evidence to confirm a positive family history as an important independent risk factor for coronary heart disease, although there may be familial aggregation of subjects with a high susceptibility to the effects of the three primary risk factors, cigarette smoking, hypertension, and hyperlipidaemia.