Abstract
International Journal of Medicine and Public Health,2017,7,1,23-27.DOI:10.5530/ijmedph.2017.1.3Published:March 2017Type:Original ArticleParental-Offspring Association of Age of Onset of Coronary Heart Disease or Stroke A Prospective Cohort Study of Parents and OffspringNessim Abu Saif, Shannon A. Allport, Ngum Kikah, and Folefac D. Atem Nessim Abu Saif1,2*, Shannon A. Allport1,3*, Ngum Kikah1, Folefac D. Atem1 1The University of Texas Health Science Center School of Public Health, Dallas, Texas, United States of America 2Trinity School of Medicine, Kingstown, St. Vincent and the Grenadines 3Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. Abstract:Objective: To investigate the effect of parental age of onset of coronary heart disease (chd) or stroke on age of onset of chd or stroke in offspring. Design: Inception cohort study. Methods: The association between age of onset of chd or stroke in offspring and maternal age of onset of chd or stroke and the association between age of onset of chd or stroke in offspring and paternal age of onset of chd or stroke were assessed using the cox proportional hazard model after conditionally imputing the censored parents (i.E. Parents who did not experience chd or stroke during the study). Results: Parental age of onset of chd was predictive of offspring age of onset of chd for both maternal age of onset of chd (p < 0.0001 N=1378) and for paternal age of onset of chd (p=0.0005 N=1194). A negative estimate of the coefficient of interest signifies that late onset of coronary heart disease in parents is protective of onset of chd in offspring. Beer intake and hdl were important confounding variables associated with parental and offspring age of onset chd. Conclusion: Using cox proportional hazard model, we found that late onset of chd or stroke in parents is cardioprotective for offspring. Parental age of onset of chd or stroke is associated with offspring age of onset of chd, and this relationship is described for each unit increase or decrease of age of onset using these statistical methods. This relationship suggests that data on parental history can be useful in the clinical setting in the determination of risk among those at intermediate levels of predicted risk using existing risk calculators. Keywords:cardiovascular disease, cerebrovascular accident, coronary heart disease, onset of cardiovascular disease, risk factor, strokeView:PDF (217.52 KB) Full Text
Highlights
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality both in the United States and worldwide.[1]
We present the importance of parental age of onset of coronary heart disease (CHD) or stroke, which was excluded from the Framingham Risk Score (FRS), and its significance as an independent predictive variable for risk assessment
As an illustration for our paper, we are interested in estimating the parameters of the Cox proportional hazards model of the relationship between parent age of onset of coronary disease or stroke as a primary predictor while controlling for the offspring’s risk factors such, smoking status, beer intake, diabetes status, high-density lipoprotein (HDL), and systolic blood pressure BMI (SBP)
Summary
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality both in the United States and worldwide.[1]. Saif et al.: Parental-Offspring Association of Age of Onset of CHD or Stroke the time-to-event outcome, offspring age of onset of CHD or stroke, while controlling for offspring modifiable risk factors This analysis enables us to interpret results in a unit scale rather than using the thresholding approach, in which the distinction of “premature” cardiovascular disease is determined using a cutoff age of 55 for males and 65 for females.[14] The thresholding approach dichotomizes the independent variable (family history of CHD or stroke) in to a “yes” or “no” binary outcome, which oversimplifies and reduces the power of the relationship between the two variables. This detailed characterization can establish a more appropriate time for the initiation of primary prevention and risk factor modification in offspring to prevent or delay the onset of CHD or stroke
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