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The importance of family history in cerebrovascular disease
C Graffagnino1, A P Gasecki, G S Doig
1Department of Medicine, Duke University Medical Center, Durham, NC.
Insights
A family history of vascular disease is linked to stroke and heart attack risk. While not an independent factor, it signals other established risks like hypertension and high cholesterol.
Area of Science:
- Neurology
- Genetics
- Epidemiology
Background:
- The genetic contribution to cerebrovascular disease is debated.
- Family history is a potential indicator of inherited risk for stroke.
Purpose of the Study:
- To investigate the association between family history and atherothrombotic infarction or transient ischemic attack.
- To determine if a family history of vascular disease influences stroke risk.
Main Methods:
- Prospective study comparing 90 stroke/transient ischemic attack patients with 90 age- and sex-matched controls.
- Data collected included medical history, family history, and physical examinations.
Main Results:
- A positive family history of ischemic heart disease was more common in patients (73%) than controls (53%).
- A positive family history of stroke was significantly more prevalent in patients (47%) versus controls (24%).
Conclusions:
- Family history of vascular disease is a marker for other risk factors, not an independent predictor.
- Established risk factors like hypertension, hyperlipidemia, and personal history of ischemic heart disease are significant independent predictors of stroke.
Background And Purpose:
The role of genetics in cerebrovascular disease remains controversial. The purpose of this study was to assess the influence of family history on atherothrombotic infarction or transient ischemic attack.
Methods:
Ninety patients with stroke or transient ischemic attack and 90 age- and sex-matched community control subjects were studied prospectively. Medical and family histories were obtained from all subjects, and a complete physical examination was performed.
Results:
Eighty-five patients and 86 control subjects knew their family history for ischemic heart disease and stroke. A positive history for ischemic heart disease was present in 62 (73%) of the patients and 46 (53%) of the control subjects (P = .019), and a positive family history for stroke was present in 38 (47%) of the patients and 21 (24%) of the control subjects (P = .014).
Conclusions:
Although a positive vascular family history was not an independent risk factor in a multivariate analysis, it was an excellent marker of the presence of other established vascular risk factors. Personal histories of ischemic heart disease, hypertension, and hyperlipidemia were found to be significant independent risk factors for stroke.