Addition of a novel, protective family history category allows better profiling of cardiovascular risk and atherosclerotic burden in the general population. The asklepios study.

Van Daele CM, De Meyer T, De Buyzere ML, Gillebert TC, Denil SL, Bekaert S, Chirinos JA, Segers P, De Backer GG, De Bacquer D, Rietzschel ER, On Behalf Of The Asklepios Investigators.

Source

Department of Cardiovascular Diseases, Ghent University Hospital, Ghent, Belgium.

Abstract

OBJECTIVES:

Whereas the importance of family history (FH) is widely recognized in cardiovascular risk assessment, its full potential could be underutilized, when applied with its current simple guidelines-based definition (cFH): presence of premature cardiovascular disease (CVD) in a first-degree relative. We tested the added value of a new, extended family history definition (eFH), also taking into account later onset of disease, second-degree relatives and number of affected relatives, on profiling cardiovascular risk and atherosclerotic burden in the general population.

DESIGN:

longitudinal population study.

SETTING:

random, representative population sample from Erpe-Mere and Nieuwerkerken (Belgium, primary care).

SUBJECTS:

2524 male/female volunteers, aged 35-55 years, free from overt CVD.

MAIN OUTCOME MEASURES:

Subjects were extensively phenotyped including presence of atherosclerosis (ultrasound) and a newly developed FH questionnaire (4 generations).

RESULTS:

Compared to cFH, eFH was superior in predicting an adverse risk profile (glycemic state, elevated blood pressure, lipid abnormalities, presence of metabolic syndrome components) and presence of atherosclerosis (all age & sex-adjusted p<0 .05="" a="" absence="" adjusting="" after="" and="" any="" atherosclerosis="" being="" breakpoints="" but="" cfh="" clear="" confounders.="" cvd="" efh="" first-degree="" for="" further="" graded="" in="" including="" informational="" interesting="" late="" most="" negative="" not="" of="" onset="" p="" particularly="" phenotype="" predictor="" relations="" relative="" remained="" showed="" significant="" study.="" subclinical="" unlike="" were="" with="">

CONCLUSIONS:

A novel, extended FH definition is superior to the conventional definition in profiling cardiovascular risk and atherosclerotic burden in the general population. There remain clear opportunities to refine and increase the performance and informational content of this simple, readily-available inexpensive tool.