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Sibling with Heart Disease Increases Your Risk as
Much as Diseased Parent
Dec. 28, 2005 – The same researchers that told us
last year having a parent with a cardiovascular disease history doubles
personal risk of the disease is closing out this year with the news that
having a sibling with cardiovascular disease carries the same or greater
risk than having a parent with the disease.
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Having a sibling with a history of cardiovascular
disease carries the same or greater risk as having a parent with a
history of the disease, according to a new report from the long-standing
Framingham Heart Study conducted by the National Heart, Lung, and Blood
Institute (NHLBI), a part of the National Institutes of Health (NIH).
Personal risk of having a cardiovascular event,
such as a heart attack, stroke, or peripheral artery disease, may be
raised by as much as 45 percent in middle-aged people whose brother or
sister has had such an event.
The study appears in the December 28, 2005, edition
of the Journal of the American Medical Association.
Even when data was adjusted for the fact that
siblings may have similar lifestyle-related risk factors and may be of
similar ages, the risk associated with having a sibling with
cardiovascular disease remained high.
Physicians determine relative risk for
cardiovascular disease by evaluating known risk factors: family history
of heart disease, age, high blood pressure, high cholesterol,
overweight, current or former smoking, physical inactivity, and
diabetes. While having a parent or sibling with heart disease has long
been suggested to increase risk, this study shows that having a sibling
with heart disease is a significant risk factor independent of other
measures.
“This study illustrates that even people who are
not at high risk based on their own health status should talk to their
doctors about the history of heart disease in their families, among
siblings as well as parents, and ask what they can do to prevent a heart
attack or stroke,” said NHLBI Director Elizabeth G. Nabel, M.D.
Researchers evaluated siblings from among 1188 men
and 1287 women, all participants in the Framingham Heart Study.
Participants were at least 30 years old at the time of a baseline
examination, and were followed for eight years for the occurrence of a
cardiovascular disease event.
“We determined that one’s risk from a sibling with
a cardiovascular disease event remains elevated after taking into
account age and other risk factors that may cluster within families. The
risk may be even higher than the risk related to having a parent with
cardiovascular disease,” said Joanne Murabito, MD, ScM, of Boston
University, the study’s lead author.
“The risk from a sibling with cardiovascular
disease is significant even in persons with borderline elevated levels
of total cholesterol, levels at which physicians are often undecided
about medication treatment.”
The Framingham Study is one of the first studies to
take an independent, unbiased look at sibling risk. Unlike other studies
of family history, which relied on often-unreliable participant recall,
this study evaluated independent data from families within the
57-year-long observational study. Participants in this evaluation were
from the study’s Offspring group, the adult children of the original
participants who first enrolled in the 1940s and 1950s.
“Our findings suggests that taking an accurate
family history should be a crucial part of every physician’s method of
assessing heart disease risk, and should go beyond a simple ‘yes’ or
‘no’ question about the presence of disease in the family,” said Dr.
Murabito.
Patients should make the effort to collect medical
history information from their siblings and parents and make sure to
inform their siblings if they have a cardiovascular disease event such
as a heart attack or stroke, she added.
“We believe that the reasons behind the strong
association of risk between siblings are environmental as well as
genetic. In addition to sharing the same genetic makeup, siblings may
share similar dietary habits and physical activity patterns in their
early years while living in the same household. These habits may
continue on into adulthood when genetic factors begin to manifest,”
Christopher O’Donnell, MD, MPH, associate director of NHLBI’s Framingham
Heart Study and the study senior author.
“While you can’t control your family history, there
are many things you can do to control your risk for heart disease,
including keeping your blood pressure, cholesterol and blood sugar under
control, maintaining a healthy weight, avoiding smoking, and getting
regular physical activity,” said Dr. O’Donnell.
In May of 2004, the Framingham Heart Study research
team demonstrated that having a parent with a cardiovascular disease
history doubles personal risk of the disease.
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