Johns Hopkins Health Alert
The Importance of Family History in Heart Disease
Did your mother or sister have a heart attack in her 50s? Did your brother or father need bypass surgery in middle age? If so, you might want to take some extra steps to protect yourself from heart disease. Here’s what you should know …
Doctors have long known that people who have a first-degree relative (a parent, sibling, or child) with early coronary heart disease are at increased risk themselves. But new research suggests that the risk of heart disease may be greater than previously thought -- especially if you're a man whose brother or sister was diagnosed with heart disease before age 60.
Having a family history of premature heart disease (heart disease in a father or brother younger than age 55 or in a mother or sister younger than age 65) is considered a risk factor for heart attacks. And people with a family history are encouraged to estimate their risk of a heart attack in the next 10 years using a system called Framingham risk scoring, which takes into account five major heart disease risk factors: age, systolic blood pressure, smoking status, total cholesterol level, and high-density lipoprotein (HDL) cholesterol level.
But according to research from Johns Hopkins, the Framingham risk score may lead to a significant underestimate of heart disease risk in some people with a family history.
The study followed 784 healthy, middle-aged people who had a brother or sister who was hospitalized for angina or a heart attack before the age of 60. Over the next 10 years, 20% of the men and 7% of the women had a heart attack or other heart-related event. But when the researchers calculated the participants' heart disease risk based on their Framingham risk score, only 12% of the men and 6% of the women should have had a cardiac event during the study. The Hopkins researchers concluded that knowing that a brother or sister has had a heart attack, particularly if you are a man, might turn out to be one of the most important factors in determining heart disease risk.
What To Do -- If you have a sibling or parent with early heart disease, talk to your doctor about what steps you can take to reduce your own risk. For example, you may need to lose weight, improve your diet, and start exercising more. Your doctor may also want you to start taking cholesterol-lowering medication, aspirin, and blood pressure medication -- even if your Framingham risk score indicates that you are only at low or moderate risk.
You should also ask your physician about a few additional tests to refine your risk. For example, a computed tomography (CT) scan to look for calcium buildup in the coronary arteries and a blood test for C-reactive protein (CRP) that measures inflammation may provide additional risk information for someone with a family history but a Framingham score that indicates only low or moderate risk.
Posted in Heart Health on March 26, 2010
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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