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Familial history of stroke and stroke risk. The Family Heart Study
1Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill 27514, USA. duanping_liao@unc.edu
Insights
A family history of stroke significantly increases stroke risk, even after accounting for other risk factors. This suggests genetic or shared environmental influences contribute to stroke development.
Area of Science:
- Epidemiology
- Cardiovascular Disease Research
- Genetics of Stroke
Background:
- Familial history of stroke is often considered a risk factor, but empirical evidence is limited.
- The Family Heart Study investigates familial, genetic, and environmental factors in cardiovascular disease.
Purpose of the Study:
- To determine if a familial history of stroke is associated with a higher prevalence of stroke.
- To analyze stroke risk in relation to paternal and maternal family history.
Main Methods:
- A standardized questionnaire assessed personal and familial stroke histories in 3,168 probands (≥45 years old) and 29,325 first-degree relatives.
- Statistical analyses included age, ethnicity, and sex adjustments, and further adjustments for cholesterol, smoking, coronary heart disease, hypertension, and diabetes.
Main Results:
- Individuals with a positive familial history of stroke had a 2.0% prevalence compared to 4.8% without (P < .01).
- Odds ratios for stroke were 2.00 (95% CI: 1.13-3.54) for paternal history and 1.41 (95% CI: 0.80-2.50) for maternal history.
- Associations remained significant after adjusting for major cardiovascular risk factors and were consistent across ethnic groups.
Conclusions:
- A positive familial history of stroke is linked to increased stroke prevalence.
- This association supports the role of genetic susceptibility, shared environment, or both in stroke etiology.
Background And Purpose:
Although familial history of stroke is generally perceived to be an important marker of stroke risk, very few epidemiological studies have been published to address this hypothesis. We sought to examine whether familial history of stroke is associated with the prevalence of stroke in the Family Heart Study, a National Heart, Lung, and Blood Institute-supported multicenter study of the familial, genetic, and nongenetic determinants of cardiovascular disease in populations.
Methods:
The personal and familial histories of stroke were assessed in 3168 individuals (probands) who were at least 45 years old and 29,325 of their first-degree relatives with the use of a standardized questionnaire.
Results:
The age-, ethnicity-, and sex-adjusted stroke prevalences were 4.8%, 4.9%, and 3.9% in probands with a positive familial, paternal, and maternal history of stroke, respectively, in comparison with 2.0% in probands without any positive familial history (P < .01). The age-, ethnicity-, and sex-adjusted odds ratios (95% confidence interval) of stroke were 2.00 (1.13, 3.54) for a positive paternal and 1.41 (0.80, 2.50) for a positive maternal history of stroke. Additional statistical adjustment for the proband's history of elevated cholesterol level, cigarette smoking status, history of coronary heart disease, hypertension, and diabetes did not alter the associations. A similar pattern was seen for African Americans and European Americans.
Conclusions:
The increased risk of stroke among persons with a positive familial history of stroke compared with those without a familial history of stroke is consistent with the expression of genetic susceptibility, a shared environment, or both in the etiology of stroke.