Family history of Cardio Vasular Disease

A family history of CHD puts women and men at increased risk for CHD, probably from a combination of genetic and environmental factors.1A history of MI in one first-degree relative doubles, and in two or more first-degree relatives triples MI risk. MI risk is strongest when MI in relatives occurs before age 55 years but is still present when MI occurs after age 55 years. The risk associated with a positive family history is independent of other known CHD risk factors. In the Nurses Health Study, women with a family history of parental MI at or below 60 years of age had 2.8 times the risk of nonfatal MI, 5 times the risk of fatal CHD, and 3.4 times the risk for angina pectoris compared with women without a history of parental MI. For women with a history of parental MI after age 60 years, there was no increase in risk for nonfatal CHD, but risk for fatal CHD was increased 2.6 times, and for angina pectoris it was increased 1.9 times compared with women with no family history of CHD. In contrast, a study of older women found no increase in CHD risk with a family history of heart attack.

Twin studies shed further light on the influence of family history on CHD risk. In a study of male and female Swedish monozygotic and dizygotic twins, among male twins the relative risk of CHD for monozygotic twins was 8.1 and the relative risk for dizygotic twins was 3.8 when one twin died of CHD before age 55 years. Among female twins, the relative risk of CHD for monozygotic twins was 15 and the relative risk for dizygotic twins was 2.6 when one twin died of CHD before age 55 years. In both monozygotic and dizygotic twins, as the age at which one twin died increased, the risk for CHD among the remaining twin decreased

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* Barrett-Connor E, Wingard DL: Sex differential in ischemic heart disease mortality in diabetics: A prospective population-based study. Am J Epidemiol 118: 489–496, 1983
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* Bates CJ, Mansoor MA, van der Pols J et al: Plasma total homocysteine in a representative sample of 972 British men and women aged 65 and over. Eur J Clin Nutr 51: 691–697, 1997
* Beard DM, Fuster V, Annergers JF: Reproductive history in women with coronary heart disease: A case-control study. Am J Epidemiol 120: 108–114, 1984