Family history as an independent risk factor for ischaemic heart disease in a low incidence area (Galicia, Spain)

Abstract

It has been suggested that a family history positive for coronary heart disease (CHD) increases the risk of CHD. We studied this association to determine the degree of risk, the independence of this association and the presence of interaction of a family history of CHD with the major known risk factors in a low incidence area. One hundred and six hospital cases (85 males and 21 females) of CHD and 106 hospital controls individually matched with each case for sex, age and place of residence (rural-urban) were studied. From every participant, information was collected on their personal and family history of cardiovascular disease and risk factors; height, weight, lipid profile and blood pressure were measured, and an electrocardiogram was recorded. Conditional logistic regression was used in the analysis. The observed odds ratio of patients suffering from CHD among those with, compared to those without, a positive family history of CHD was 4.95 (95% confidence interval = 1.27-19.28) after adjusting for the major known risk factors in each individual and their families (no interaction term remained in the model). The results support the hypothesis that a family history of CHD, acting through mechanisms other than known risk factors or their familial aggregation, is an independent risk factor for CHD even in a low incidence area. No interaction effect was observed between family history and the presence of the three major risk factors of CHD. This should help to identify individuals at greater risk of CHD.

How to evaluate interaction between causes: a review of practices in cardiovascular epidemiology

“…Typical hypotheses postulate an increased risk of coronary heart disease (CHD) from interaction between, for example : 1 cholesterol and hypertension [1,2] ; 2 family history and other major risk factors [3][4][5] ; empirical criteria of interaction can be derived. In principle, the method to apply consists of comparing risk differences for one risk factor of interest across strata of the other.…”

Paternal or maternal history of cardiovascular disease and the risk of cardiovascular disease in offspring. A systematic review and meta-analysis

“…1. An additional two articles were found through manual reference check, resulting in 26 articles included in the meta-analysis [1,3,5,6,[10][11][12][13][14][15][16][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Of these 26 articles, four were based upon data derived from the Framingham cohort (two of offspring cohort [1,15] and two of original cohort [14,16]) and two articles were derived from the same Finnish population [28,29].…”

“…Included articles were published in the period 1989-2012 and were case-control (n = 8 [21][22][23][24]27,31,33,34]), cross-sectional (n = 2 [6,30]) and cohort studies (n = 16 [1,3,5,[10][11][12][13][14][15][16]25,26,28,29,32,35]). The number of included participants ranged from 106 to 248,490 with a median of 4933 participants (interquartile range 1699-24483).…”

A new estimate of family disease history providing improved prediction of disease risks

“…Disease history of other family members is highly correlated with the disease outcome of an individual due to common environmental and inherited genetic factors [1–3]. The family history of an individual has been shown to be an important predictor of the individual’s risk of diseases [4–8].…”

“…The results show that assessing family history can improve the prediction of disease risks and the SLFS has strongest positive associations with both myocardial infarction and stroke. 1270 R. FENG ET AL.of an individual due to common environmental and inherited genetic factors [1][2][3]. The family history of an individual has been shown to be an important predictor of the individual's risk of diseases [4][5][6][7][8].…”