Screening individuals and families with premature coronary heart disease: a clinical and public health challenge.

Abstract

See doi:10.1016/S1095-668X(02)00386-Xfor thearticle to which this editorial refers. In this issue De Sutter and colleagues1 make several important and timely contributions First, they summarize the data from numerous retrospective and prospective epidemiologicstudies of family history and premature onset of coronary heart disease. The data seem to consistently show that individuals with a positive family history of premature onset of coronary heart disease have an increased risk, which is independent of other coronary risk factors. The magnitude ofthe increased risk is generally about 2-fold with somewhat higher estimates present for thosewhose first-degree relatives had earlier onset of premature coronary heart disease. Second, they discuss why family history may be used to target populations for more intensive risk factor modification. Specifically, if a patient hasa 10-year risk of coronary heart disease of about 10% based on the existing modifiable coronary risk factors, the presence of a positive family history of premature coronary heart disease may increase …