Family History
 

• • The process of atherosclerosis or plaque buildup that results in cardiovascular disease (CVD)  is very complex and involves multiple genetic, environmental and personal risk factors. A family history of CVD in a first degree relative represents the net effect of shared genetic, biochemical, behavioral and environmental components and represents an important independent risk factor for future CVD.

  • At a given level of modifiable risk factors, those with family history of premature heart disease has double the risk of heart disease compared to those without.  The risk may be as high as 12-fold when multiple family members in different generations died at a young age. The risk for CVD in offspring or sibling is strongly and inversely related to the age of the affected individual at the time of the first event. The risk of recurrent heart attack or stroke is even stronger for those with personal history of early heart disease.

  • Cardiovascular diseases include not only heart attack, stroke or sudden cardiac death, but also coronary angioplasty and/or stent, and coronary artery bypass surgery. However, the vast majority of the people with coronary artery disease (CAD) have had no symptoms, therefore are undiagnosed.  Such silent heart disease can be readily and inexpensively diagnosed with a heart scan.

  • Family history of premature heart disease is defined as the presence of premature CAD in first degree relatives before age 55 in a male and before age 65 in a female. By definition, the history of heart disease in a male relative after the age of 55 or female relative after the age of 65 is not considered a family history of premature heart disease. Since the parents and siblings of children and adolescents are usually young themselves, when evaluating family history in a child, history should also be ascertained for the occurrence of cardiovascular disease in grandparents, aunts and uncles.

  • Identification of a positive family history for CV D should lead to evaluation of all family members.  The evaluation should include measurement of lipid profile and Lipoprotein (a)─ the foremost genetic factor for family history of early heart attack and death.​