Paternal or maternal history of cardiovascular disease and the risk of cardiovascular disease in offspring. A systematic review and meta-analysis

Abstract

BackgroundParental history of cardiovascular disease (CVD) is an established risk factor for the development of CVD in offspring. Several studies have suggested that a maternal transmission of CVD is more important for the development of CVD than paternal transmission. MethodsA systematic search and meta-analysis were conducted, using the Medline and Embase databases. Included were cohort, case–control and cross-sectional studies (n=26) focusing on the relation between paternal and maternal histories of cardiovascular disease and offspring CVD (myocardial infarction, stroke or cardiovascular mortality). The pooled estimates were calculated using a random-effects model. ResultsThe pooled OR of CVD in offspring having a positive paternal history of CVD compared to not having a positive parental history was 1.91 (95% CI 1.56–2.34; I253%), the RR1.54 (95% CI 1.33–1.77; I296%). The OR of a maternal history was 2.16 (95% CI 1.71–2.74; I250%), RR1.59 (95% CI 1.38–1.84; I290%). Regarding different age limits, a maternal history <50years (3.15, 95% CI 2.18–4.55) and paternal history <55years (2.82, 95% CI 2.25–3.54) were associated with the highest cardiovascular risk. Additional analyses for sons demonstrated an estimate for a positive paternal history of 1.55 (95% CI 1.39–1.71; I274%) and 1.56 (95% CI 1.46–1.67; I216%) for maternal history. For daughters, the estimate for paternal history was 1.48 (95% CI 1.26–1.74; I273%) and 1.79 (95% CI 1.50–2.13; I268%) for maternal history . ConclusionsThe conferred risk of CVD in offspring was not substantially different between positive paternal and maternal histories of CVD, the highest risk was observed for maternal history <50years. Since a positive parental history of CVD involves an increased cardiovascular risk, parental history inquiry is useful in clinical practice. No distinction has to be made whether the affected parent is the mother or the father.