Distribution of risk factors in parents and siblings of patients with early coronary artery disease

Abstract

Original ArticleCoronary artery disease is the major cause of death in the Brazilian population 1 and is directly related to the number and intensity of risk factors 2 , which may be generically divided into unchangeable (age and sex) and changeable. The major changeable risk factors are obesity, sedentary lifestyle, systemic arterial hypertension, smoking, dyslipidemia, and diabetes. Smoking and sedentary lifestyle are basically behavioral, and the remaining risk factors are associated with genetic and environmental components. Studies in different populations have shown the greater importance of environmental and behavioral components in the genesis of the atherosclerotic process 3 . A classical example is the greater prevalence of the disease in individuals migrating from a more favorable environment to one with a more atherogenic profile 4 . Likewise, some studies 5,6 have shown the importance of the microenvironment, in particular the family, where genetic influences and lifestyle are equally important. Offspring of parents with systemic arterial hypertension or with dyslipidemia have a greater incidence of diseases whose phenotypes are influenced by the familiar lifestyle. The result of this interaction is responsible for atherosclerotic disease, which normally affects males after the 6th decade and females almost 1 decade later 7 . In younger patients with coronary artery disease, a greater participation of the genetic component has been discussed. Despite the existing controversies, a familiar analysis may directly or indirectly facilitate the detection and quantification of which component, genetic or environmental, has the greatest impact on early atherosclerotic disease, and, consequently, on its future control. Therefore, the major objective of this study was to analyze the prevalence of risk factors in families of patients with early systemic arterial disease, and to detect the importance of parents in the vertical transmission of these risk factors. MethodsThis study prospectively analyzed the distribution of the major risk factors of parents and siblings of 42 conse- 102 RF,4,3,2, and 1 were observed in, respectively,5,15,15,and 7 Objective -Early coronary artery disease (CAD) is associated with risk factors (RF). Offspring of parents with a RF have a greater prevalence of them. However, the distribution of RF in parents and siblings of patients with early CAD is unknown. Methods -The study comprised the parents and siblings of 42 patients with early CAD (≤ 45 years), 29 males. Their mean age was 39.5±3.7 years. The following major RF were analyzed: smoking (≥ 5 cigarretes/day), hypercholesterolemia (total cholesterol ≥ 200 mg/dL), hypertension (diastolic blood pressure ≥ 90 mmHg), and diabetes (glycemia ≥ 126 mg/dL). Results -Of a total of

Family History of Premature Coronary Artery Disease (P-CAD)—A Non-Modifiable Risk Factor? Dietary Patterns of Young Healthy Offspring of P-CAD Patients: A Case-Control Study (MAGNETIC Project)

“…Higher prevalence of smokers among cases can create a concern as to whether cases were less health-orientated than controls. Nonetheless, previous studies showed that patients with P-CAD are more often smokers and have less favorable dietary patterns, than patients without P-CAD [ 6 , 9 , 11 , 29 , 30 , 31 ]. Therefore, higher prevalence of smokers among cases may be caused by parental modelling and parenting behavior effects on offspring, rather than control group selection [ 35 , 36 , 37 , 46 ].…”

“…Inadequate nutrition and smoking are highly prevalent among cardiovascular patients [ 9 ] and may cluster with other unfavorable behaviors such as excessive drinking and low activity level [ 10 ], increasing the cumulative effect of multiple risks. A study among young adults with P-CAD revealed that their smoking habit was correlated with parental smoking [ 11 ]. The study, however, did not provide information regarding characteristics of the diet in affected families.…”

Dislipidemia entre crianças e adolescentes de Pernambuco

“…This frequency is lower than that observed in schoolchildren (35%) and in several adult populations (40%) from Brazil 19,32 . However, any increase in the prevalence of dyslipidemia and overweight in adults and mainly in children is very important because they are among the most important risk factors for the development of coronary artery disease, one of the three main causes of morbidity and mortality in Brazil 11,33,34 .…”

Falta de associação entre o sistema Lewis e obstrução coronariana

“…Essas diferenças demonstram que os dois grupos de pacientes não estavam totalmente pareados, mas são justificáveis, pois idade avançada e sexo masculino constituem fatores de risco para doenças cardíacas resultantes de obstrução coronariana. Os resultados verificados nesse trabalho são coincidentes com aqueles que integram estudos sobre taxas de mortalidade para doenças cardiovasculares no Brasil, [34][35][36][37] além daqueles divulgados pelo Ministério da Saúde no ano de 2002. 38 As freqüências dos fenótipos eritrocitários Lewis dos indivíduos selecionados no presente estudo, independente da presença ou não de obstrução coronariana, apresentaram valores semelhantes àqueles estimados para a população brasileira.…”