Abstract
ObjectiveThe risk for cardiovascular disease (CVD) is higher for individuals with a first-degree relative who developed premature CVD (with a threshold at age 55 years for a male or 65 years for a female). However, little is known about the effect that each unit increase or decrease of maternal or paternal age of onset of CVD has on offspring age of onset of CVD. We hypothesized that there is an association between maternal and paternal age of onset of CVD and offspring age of onset of CVD.MethodsWe used the Framingham Heart Study database and performed conditional imputation for CVD-censored parental age (i.e. parents that didn’t experience onset of CVD) and Cox proportional regression analysis, with offspring’s age of onset of CVD as the dependent variable and parental age of onset of CVD as the primary predictor. Modifiable risk factors in offspring, such as cigarette smoking, body mass index (BMI), diabetes mellitus, systolic blood pressure (SBP), high-density lipoprotein (HDL) level, and low-density lipoprotein (LDL) level, were controlled for. Separate analyses were performed for the association between maternal age of onset of CVD and offspring age of onset of CVD and the association between paternal age of onset of CVD and offspring age of onset of CVD.ResultsParental age of onset of CVD was predictive of offspring age of onset of CVD for maternal age of onset of CVD (P < .0001; N = 1401) and for paternal age of onset of CVD (P = 0.0134; N = 1221). A negative estimate of the coefficient of interest signifies that late onset of cardiovascular events in parents is protective of onset of CVD in offspring. Cigarette smoking and HDL level were important associated confounders.ConclusionsOffspring age of onset of cardiovascular disease is significantly associated with both maternal and paternal age of onset CVD. The incorporation of the parameters, maternal or paternal age of onset of CVD, into risk estimate calculators may improve accuracy of identification of high-risk patients in clinical settings.
Highlights
Cardiovascular disease (CVD), defined as coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, and heart failure, is the leading global cause of death, accounting for over 30 percent of all deaths worldwide– 17.3 million deaths per year
Parental age of onset of CVD was predictive of offspring age of onset of CVD for maternal age of onset of CVD (P < .0001; N = 1401) and for paternal age of onset of CVD (P = 0.0134; N = 1221)
Offspring age of onset of cardiovascular disease is significantly associated with both maternal and paternal age of onset CVD
Summary
Cardiovascular disease (CVD), defined as coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, and heart failure, is the leading global cause of death, accounting for over 30 percent of all deaths worldwide– 17.3 million deaths per year. Though the death rate due to CVD has decreased slowly over the last 5 decades, heart disease remains the leading cause of death in the United States, and caring for patients with poor cardiovascular health continues to be one of the largest burdens on the health care system today. Shared environmental risk factors, such as the presence of smoke and unhealthful diet, accounts for some of the increased risk of CVD in offspring with affected parents. Genetic markers involved in lipoprotein handling, endothelial integrity, arterial inflammation, and thrombosis formation have been linked to increased risk of CVD in families [12, 13]
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