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Senior Citizen Health & Medicine
Your Fate Determined When Brother or Sister have
Heart Attack
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The
way we were! |
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Hereditary link puts male sibs at higher risk, but
sisters not off the hook
Oct. 30, 2007 – If you are a healthy male and your
sister or brother has a heart attack, your risk of the same jumps
dramatically. If you are a health female and your sister of brother has
a heart attack, your risk goes up too, but not so much.
The genetic family ties that bind brothers and
sisters also link their risk for developing clogged arteries and having
potentially fatal heart attacks, scientists at Johns Hopkins report. And
according to researchers, brothers bear the brunt of the burden.
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In a study to be published in the Nov. 1 edition of
the American Journal of Cardiology, the Hopkins team found that,
regardless of age or lifestyle factors, if any sibling, brother or
sister, suffers a heart attack, or chest pain from blocked arteries, the
chances of any healthy brothers developing similar problems rises within
10 years by 20 percent.
For sisters, the risk was less but still evident,
at 7 percent. And, researchers say, the younger the age of the sibling
who first develops heart disease, the greater the risk that other
brothers’ and sisters’ arteries will also narrow, harden and clog.
“The risk was greater than previously thought and
makes clear the existence of a substantial, if uneven hereditary link in
heart disease among brothers and sisters,” says senior study
investigator Diane Becker, M.P.H., Sc.D.
Becker adds that, eventually, a genetic blood test
to assess sibling risk in families with a history of heart disease could
reduce that risk by encouraging earlier lifestyle and drug
interventions.
“In the meantime,” she says, “brothers and sisters
in families with a history of heart disease really need to monitor their
health more closely and in consultation with their physician, and
consider if drug therapy and better diet, exercise and lifestyle habits
are needed.”
Becker, a professor at The Johns Hopkins University
School of Medicine and Bloomberg School of Public Health, and her team
of researchers say they were most surprised by the very high level of
sibling risk.
Existing statistical risk analyses, such as the
Framingham Risk Score, would not predict so high a disease risk among
men until well into their 80s or 90s, she says. The Framingham score,
she notes, determines how likely a person is to suffer fatal or nonfatal
coronary heart disease within 10 years and calculates risk based on a
summary score of such factors as age, sex, cholesterol levels, blood
pressure, diabetes and smoking.
“Knowing that your brother or sister had a heart
attack, or that a sibling suffered chest pain and was rushed to a
hospital stand out as possibly the most important predictor of whether
or not another sibling develops blocked arteries, which can lead to a
fatal heart attack,” says study lead investigator Dhananjay “Jay” Vaidya,
M.B.B.S., Ph.D., an assistant professor at Hopkins.
“Genetic factors are clearly to blame,” he says,
“although just how that works is unclear.” Vaidya suggests that genes
could make these people more susceptible to known disease risk factors,
or that genes could make people more vulnerable to some as-yet-unknown
risk factor.
In their study, Becker’s group used information
collected from 1983 to 2006 as part of a larger study known as the
Sibling and Family Heart Study, which involves risk-factor monitoring in
800 siblings between the ages of 30 and 60. Study participants come from
nearly 350 families in the Baltimore region and were generally healthy,
but all had at least one sibling with premature coronary heart disease
that had required hospitalization. Half of the participants were women;
20 percent were black.
Blood tests and physical exams were conducted at
the beginning of the study to assess each individual’s risk factors.
Earlier findings by the team in 2005 showed that
people who have a family history of heart disease needed to keep their
weight down. In these families, the Hopkins team found that siblings who
were obese or overweight had a 60 percent increased risk of suffering a
serious heart ailment, such as a heart attack, before the age of 60.
As follow-up to their latest findings, Becker says
she and her colleagues have done a genome-wide scan at deCode Genetics
in Reykjavik, Iceland, a company known for its rapid genetic study of
that country’s genetically isolated inhabitants to hunt for the genes
linked to sibling risk.
“If we can crack this code, then we hope to develop
a blood test for identifying families at risk long before any symptoms
manifest themselves,” she says.
Notes:
Funding was provided by the National Institutes of
Health and the Johns Hopkins Clinical Research Center. Other Hopkins
investigators in this research were Lisa Yanek, M.P.H.; Taryn Moy, M.S.;
and Lewis Becker, M.D. Further assistance with results analysis was
provided by Thomas A. Pearson, M.D., at the University of Rochester
Medical Center, in New York.
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