Risk Factors In First-degree Relatives Research Articles

Prevalence of Traditional Risk Factors in First-Degree Relatives of Patients With Established Cardiovascular Disease.

World Health Organization (WHO)/International Society of Hypertension (ISH) risk prediction charts are useful for predicting 10-year combined myocardial infarction and stroke risk (fatal and non-fatal). Hence the current study was conducted to assess the 10-year risk of cardiovascular disease among adults in Ahmedabad, India. The primary aim of the study was to assess the cardiovascular risk among first-degree relatives of patients attending the outpatient clinic. Also, to create awareness regarding assessment of cardiovascular risk among the studied group. A cross-sectional study was carried out among 372 first-degree relatives of patients at an out-patient cardiology clinic present in Vadaj, Ahmedabad. The WHO/ISH risk prediction chart for South-East Asia Region D (SEAR D) was used for calculating the 10-year cardiovascular risk. A maximum (80.10%) of the study participants were in the low-risk (<10%) category followed by 8.33% for moderate-risk (10-20%), 7.25% for moderately high-risk (20-30%), 2.42% for high-risk (30-40%) and 1.88% for very high-risk (>40%). WHO/ISH risk prediction charts provide a quick and effective way to assess and categorize the population in a low-resource setting which in turn helps in delivering focused intervention to the high-risk groups.

Prevalence and risk factors for impaired glucose regulation among first-degree relatives of patients with type 2 diabetes mellitus in Maiduguri, Northeastern Nigeria

Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of developing impaired glucose metabolism is thought to be higher in first-degree relatives (FDRs) of those with T2DM. The aim of this study was to estimate the prevalence of impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) and its associated risk factors in FDRs of patients with T2DM. Materials and Methods: This is a cross-sectional descriptive study of 320 cases (FDRs of T2DM outpatients) aged ≥25 years (145 males and 175 females) and 160 controls (76 males, 84 females) who were age and sex matched. All subjects underwent anthropometric, physical activity, and laboratory assessments after an overnight fast. Oral glucose tolerance test with 75g anhydrous glucose was administered. Fasting plasma glucose of 6.1–6.9 mmol/L and 2-h post-fasting glucose value of 7.8–11.0 mmol/L were used to define IFG and IGT, respectively. Statistical analysis was carried out using the Statistical Package for the Social Sciences software, version 20 (SPSS, Chicago, Illinois), and P value of <0.05 was considered significant. Results: The mean (standard deviation) age of the cases and controls was 38.4 (12.3) and 38.9 (10.3) years, respectively, P = 0.66. The prevalence rates of both IGT and IFG in cases and controls were (28.1% vs. 18.1%, P = 0.019 and 10.3% vs. 5.6%, P = 0.0001). The prevalence of IGT and IFG was found to be higher among females, P < 0.05. Multivariate analysis revealed abnormal waist circumference, being FDR, and elevated systolic blood pressure as risk factors for both the IGT and IFG, P < 0.05. Conclusion: FDRs of patients with T2DM are at higher risk of IGT or IFG. The risk increases with the development of obesity and elevated blood pressure in them.

Risk modeling in prospective diabetes studies: Association and predictive value of anthropometrics

AimsThis study aimed to introduce and apply modern statistical techniques for assessing association and predictive value of risk factors in first-degree relatives (FDR) of patients with diabetes from repeatedly measured diabetes data. MethodsWe used data from 1319 FDR’s of patients with diabetes followed for 8 years. Association and predictive performance of weight (Wt), body mass index (BMI), waist and hip circumferences (WC and HC) and their ratio (WHR), waist-height ratio (WHtR) and a body shape index (ABSI) in relation to future diabetes were evaluated by using Cox regression and joint longitudinal-survival modeling. ResultsAccording to Cox regression, in total sample, WC, HC, Wt, WHtR and BMI had significant direct association with diabetes (all p < 0.01) with the best predictive ability for WHtR (concordance probability estimate = 0.575). Joint modeling suggested direct associations between diabetes and WC, WHR, Wt, WHtR and BMI in total sample (all p < 0.05). According to LPML criterion, WHtR was the best predictor in both total sample and females with LPML of −2666.27 and −2185.67, respectively. However, according to AUC criteria, BMI had the best predictive performance with AUC-JM = 0.7629 and dAUC-JM = 0.5883 in total sample. In females, both AUC criteria indicated that WC was the best predictor followed by WHtR. ConclusionWC, WHR, Wt, WHtR and BMI are among candidate anthropometric measures to be monitored in diabetes prevention programs. Larger multi-ethnic and multivariate research are warranted to assess interactions and identify the best predictors in subgroups.

Metabolic syndrome, diabetes and inadequate lifestyle in first-degree relatives of acute myocardial infarction survivors younger than 45\xa0years old

BackgroundA premature myocardial infarction (PMI) is usually associated with a familial component. This study evaluated cardiovascular risk factors in first-degree relatives (FDR) of patients with PMI not presenting the familial hypercholesterolemia phenotype.MethodsA cross-sectional study comprising FDR of non-familial hypercholesterolemia patients who suffered a myocardial infarction <45-years age matched for age and sex with individuals without family history of cardiovascular disease. Subjects were evaluated for presence of the metabolic syndrome and its components, lifestyle, statin therapy, and laboratory parameters.ResultsThe sample was composed of 166 FDR of 103 PMI patients and 111 controls. The prevalence of smoking (29.5 vs. 6.3%; p < 0.001), prediabetes (40.4 vs. 27%; p < 0.001), diabetes (19.9 vs. 1.8%; p < 0.001), metabolic syndrome (64.7 vs. 36%; p < 0.001), and dyslipidemia (84.2 vs. 31.2%; p = 0.001) was greater in FDR. There was no difference on the prevalence of abdominal obesity between groups. In addition, FDR presented higher triglycerides (179.0 ± 71.0 vs. 140.0 ± 74.0 mg/dL; p = 0.002), LDL-cholesterol (122.0 ± 36.0 vs. 113.0 ± 35 mg/dL; p = 0.031), non-HDL-cholesterol (157.0 ± 53.0 vs. 141.0 ± 41.0 mg/dL; p = 0.004), and lower HDL-cholesterol (39.0 ± 10.0 vs. 48.0 ± 14.0 mg/dL; p < 0.001) than controls. Thyrotropin levels (2.4 ± 1.6 vs. 1.9 ± 1.0 mUI/L; p = 0.002) were higher in FDR. The risk factor pattern was like the one of index cases. Only 5.9% (n = 10) of FDR were in use of statins.ConclusionsFDR of non-familial hypercholesterolemia patients with PMI presented an elevated prevalence of metabolic abnormalities, inadequate lifestyle and were undertreated for dyslipidemia.

Insulin resistance and elevated C-reactive protein among first-degree relatives of ischemic stroke patients

BackgroundFamily history is one of the non-modifiable risk factors for ischemic stroke. Atherosclerosis and thrombosis are the two major mechanisms for cardiovascular disease and stroke. Screening of family members is an important method to identify individuals at risk. Therefore, this study was planned to assess the atherosclerotic risk factors in first-degree relatives of patients with ischemic stroke. MethodologyCase group included 40 first-degree relatives of ischemic stroke patients between 30 and 50 years of age. Forty age and gender matched apparently healthy subjects without major risk factors were recruited as controls. Their blood samples were analysed for routine biochemical parameters, Fasting Insulin, high sensitivity C-reactive protein and Homocysteine. ResultsFirst-degree relatives showed dyslipidemia (High total cholesterol, elevated Low Density Lipoprotein and elevated Non-High Density Lipoprotein), hyperinsulinemia and insulin resistance compared to controls. They had high levels of high sensitivity C-reactive protein (p=0.045). There was positive correlation between fasting insulin and Homeostasis Model Assessment of Insulin Resistance with high sensitivity C-reactive protein among first-degree relatives. ConclusionFirst-degree relatives of ischemic stroke patients exhibited hyperinsulinemia, Insulin resistance and dyslipidemia. Insulin resistance, a low grade inflammatory state that leads to increased C-reactive protein which triggers the development of atherosclerosis. So screening for insulin resistance and dyslipidemia in first-degree relatives of ischemic stroke patients may help in preventing adverse vascular events.

A Comparative Study of Serum Uric Acid Level in First Degree Relatives of Patients of Acute Coronary Syndrome and In Normal Subjects

1 Demonstrator, Department of Physiology, Assam Medical College, Dibrugarh-786002, Assam, India 2 Professor, Dept of Physiology, Fakhruddin Ali Ahmed Medical College, Barpeta-781301, Assam, India 3 Professor, Department of Cardiology, Assam Medical College, Dibrugarh-786002, Assam, India Corresponding Author Dr Subha Bhakta Department of Physiology, Assam Medical College, Dibrugarh, Assam-786002 Email: subha84b@gmail.com , Mobile no: 9435678993 ABSTRACT Background: Ischaemic heart disease (IHD) is a leading cause of worldwide morbidity and mortality. A number of risk factors have been described in the etiology of IHD. Uric acid is one of the modifiable risk factor plays a role in the development of cardiovascular morbidity in the general population. We can delay the development of IHD by better control of uric acid levels in first degree relatives (FDRs) of IHD patients. We conducted a study in which we were assess serum uric acid levels independent of other established risk factors in FDRs of IHD patients and in normal subjects. Method: Sixty first degree relatives of IHD patients were selected, who were the attendants of the patients coming to the cardiology OPD and patients admitted to Intensive Care Unit (ICU), Assam Medical College Dibrugarh. An equal number of subjects were selected as a control group who had no family history of IHD. After a detailed clinical history and physical examination, fasting blood samples were collected. Blood glucose, lipid profile and serum uric acid levels were estimated. Results: The serum uric acid levels were found to be significantly high in first degree relatives of acute coronary syndrome in comparison to healthy individuals. Conclusion: . We therefore conclude that high uric acid has a definite role in Cardiovascular disease in first degree relatives.

Metabolic syndrome, diabetes and inadequate lifestyle in first-degree relatives of acute myocardial infarction survivors younger than 45 yrs. old

Background A premature myocardial infarction (PMI) is usually associated with a familial component. This study evaluated cardiovascular risk factors in first-degree relatives (FDR) of patients with PMI not presenting the familial hypercholesterolemia phenotype.

INFLUENCE OF THE FACTOR FAMILY HISTORY ON THE RISK OF CORONARY HEART DISEASE

For the purpose of investigating the correlation between incidence of myocardial infarction (MI) and family history of cardiovascular disease (CVD), the study of prevalence of CVD among the first-degree relatives of patients with a known MI episode has been conducted. Medico-genetic files of two groups of patients with evidence of MI on ECG at rest have been analyzed: first group comprising patients who had an episode of MI before 55 years of age and second group comprising patients who had an episode after 55 years of age. A fairly high percentage of CVD in families of majority of patients with a known episode of MI has been noticed. However, this study has demonstrated a relatively low prevalence of coronary artery disease (CAD) and MI, including MI episodes before the age of 55, among fathers of patients from both groups. Moreover, occurrence of CAD and MI in fathers of the subgroup of patients who suffered from MI before 50 years of age of these patients practically showed no difference from that of subgroups of patients with episodes of MI at an older age. A fairly large amount of patients in both groups had no history of CAD in their families (41,5% and 41,2%, respectively). Considering the results mentioned above, there is no evidence to suggest that a predisposition of patients to MI episode at a younger age increases with existence of this disease in fathers of such patients. Results of our study suggest that increased presence of CVD and risk factors in first-degree relatives increases the probability of MI CAD in most patients of both groups regardless of the age of development of an MI episode.

Relative Familial Clustering of Cerebral Versus Coronary Ischemic Events

Few population-based studies have ascertained both cerebral and coronary events or considered their relative heritability. Differences in heritability of transient ischemic attack and ischemic stroke versus acute coronary syndromes (ACS) may inform risk prediction, genetic studies, and understanding of disease mechanisms. In a population-based study of all acute vascular events, irrespective of age, we studied family history of myocardial infarction (MI), stroke, and related risk factors in first-degree relatives. To allow for differences in rates of affected first-degree relatives caused by differences in disease incidence, we looked at the extent to which parental history was associated with affected siblings within disease category. Nine hundred six probands (604 men; mean age, 70 years) with ACS and 1015 (484 men; mean age, 73 years) with cerebral events had complete family history data. In ACS probands, parental MI was associated with MI in ≥1 sibling (1 parent with MI: odds ratio, 1.48; 1.04 to 2.10; P=0.03; both parents with MI: odds ratio, 5.97; 3.23 to 11.03; P<0.0001). In probands with cerebral events, however, parental stroke was not associated with sibling stroke. The overall frequency of ≥2 siblings with the same condition was also greater in probands with ACS than in those with cerebral events (odds ratio, 5.43; 3.03 to 9.76; P<0.00001), despite similar overall incidence of MI and stroke in our study population. One hundred forty-two (15.7%) cases of ACS occurred in families with ≥2 affected first-degree relatives compared with 56 (5.1%) transient ischemic attack/strokes. All results were similar when analyses were confined to probands with MI only versus stroke only, and independent of smoking. Heritability of coronary events was greater than that of cerebral events, such that MI was more likely to cluster in families than was stroke.

Cardiovascular risk factors in first-degree relatives of patients with hypertension*

Objective: To evaluate the prevalence of cardiovascular risk factors (CRF) and absolute risk (AR) among first-degree consanguinity relatives of Colombian patients with hypertension. Methods: The study comprised 227 relatives (siblings and children of both sexes, between 12 and 40 years of age) and 204 hypertensive patients 34-84 years old from Quindío, Colombia. Lipid profile, glycemia, smoking, body mass index, and blood pressure were analyzed, and the AR of cardiovascular disease (CVD) to 10 years was estimated. Relatives were divided into two groups: GF1 relatives 18 years. Results: three or more CRF were found in the three groups. The prevalence for smoking was 20.1%, 9.1%, and 15.9% in patients, GF1, and GF2, respectively. Hypercholesterolemia was 42.2%, 15.2%, and 18.6% in patients, GF1, and GF2, respectively. The prevalence of low HDL-c levels was 50.5%, 44.9%, and 63.6% in relatives, GF1, and GF2, respectively. Obesity was present alone in patients, (32.4%) and GF2 (10.8%). The AR was 19.6 and 6.4 in male and female patients, respectively; 0.31 and 0 in GF1 females and males, respectively, and in GF2 it was 1.5 and 0.15 in males and females, respectively. Conclusions: Patients and relatives had more than three CRFs. HDL-c was low in all three groups. The AR was high in the young relatives. Programs are needed for weight, smoking, sedentary and dyslipidemia control to prevent or delay the development of CVD in relatives.

Investigation on the risk factors in first-degree relatives with normal glucose tolerant of type 2 diabetics' patients in Chanzhi, Shanxi

Investigation on the risk factors in first-degree relatives with normal glucose tolerant of type 2 diabetics' patients in Chanzhi, Shanxi

High serum Abeta and vascular risk factors in first-degree relatives of Alzheimer's disease patients.

The main objective of this study was to determine whether elevated blood beta-amyloid (Abeta) levels among the first-degree relatives of patients with Alzheimer's Disease (AD) are associated with vascular risk factors of AD. Serum Abeta was measured in samples from 197 cognitively normal first-degree relatives of patients with AD-like dementia. Study participants were recruited as part of an ancillary study of the Alzheimer's Disease Anti-inflammatory Prevention Trial (ADAPT subpopulation). The ADAPT subpopulation was found to be similar in age, sex, and ethnicity to another cognitively normal cohort (n = 98). Using cross-sectional analyses, we examined the association of Abeta with blood pressure, lipid levels, apolipoprotein E genotypes, and the use of prescribed medication to treat vascular risk factors in the ADAPT subpopulation. Abeta(1-40) was positively associated with age, use of antihypertensives, and serum creatinine, and we observed a marginal negative interaction on Abeta(1-40) associated with systolic blood pressure and use of antihypertensives. Serum Abeta(1-42) was associated with statin use and a positive correlation of Abeta (1-42) with HDL was observed among statin nonusers. These findings suggest that high Abeta in the periphery among the family history-enriched cohorts may be due to enrichment of vascular risk factors and may reflect presymptomatic AD pathology. It remains to be determined whether the association of Abeta with medications used for treating vascular risk factors indicates prevention of AD. Longitudinal evaluation of blood Abeta in this cohort will provide a better understanding of the significance of this association in AD etiology.

Impact of Metabolic Syndrome Risk Factors in First-Degree Relatives of Type 2 Diabetic Patients

Family members of patients with an established diagnosis of type 2 diabetes mellitus (T2DM) are theoretically at risk of having the metabolic syndrome (MetS). A sample of these family members was studied from a population in a small township in Argentina, which has a high prevalence of T2DM. We examined the clinical and metabolic characteristics of 132 first-degree relatives of T2DM patients (FDR) and 112 age-matched controls. The subjects were categorized according to the International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria for MetS. The prevalence of MetS in the FDR group was 34.8 (IDF) and 26.5% (NCEP-ATPIII) respectively, which was significantly different to the prevalence in controls (p < 0.025). According to IDF criteria, the most prevalent factors among FDR subjects with MetS were low HDL-cholesterol (87%) followed by hypertriglyceridemia (69.5%). In the MetS group, which ranged between 20-29 years old (36%), the major risk factor in women was a low HDL-cholesterol serum level. In the MetS group, which ranged between 30-39 years old (44.4%), the most important risk factor in men was hypertriglyceridemia. This study revealed that the prevalence of MetS is high in young FDR adults, who need urgent preventive treatment, including lifestyle changes. The risk of developing T2DM is five times higher in non-diabetic people with MetS than in those without the syndrome.

Cardiovascular risk factors in first-degree relatives of patients with premature coronary artery disease

Objective — The objective of this study was to evaluate the prevalence of coronary risk factors among Iranian first-degree relatives of patients with premature coronary artery disease (PCAD) and compare them with the general population.Methods and results — The study comprised 144siblings and offspring (aged 25-64years) of patients with angiographically documented PCAD (< 55years in men and < 65years in women). Body mass index, blood pressure and smoking were investigated. Fasting venous blood was analysed for lipids and fasting plasma glucose. The means of measured values and prevalence of risk factors were compared with the results obtained from the Tehran University Population Laboratory Study. Two or more atherosclerosis risk factors were found in 76% of men and 50.3% of women. Prevalence of smoking, obesity, hypertension and diabetes was 24.3%, 30%, 29.9% and 6.9%, respectively. Total cholesterol and LDL-C levels were higher than desirable in 36.8% and 15.3% of our subjects, respectively, 14.6% had lower HDL-C values and 31.9% presented hypertriglyceridaemia. Overall, 60.4% of cases revealed at least one of the lipid abnormalities. Compared with the Tehran University Population Laboratory Study men showed a higher prevalence of high LDL and triglyceride (TG) levels and obesity. High LDL-C and smoking were found to be more prevalent among women with a family history of premature CAD.Conclusions — The prevalence of coronary risk factors among first-degree relatives of patients with premature CAD is high, especially in men. Risk factor identification and modification should be considered in individuals with a positive family history of premature CAD.

High prevalence of major cardiovascular risk factors in first-degree relatives of individuals with familial premature coronary artery disease—The GENECARD project

Background Hypertension, hypercholesterolemia, obesity and smoking are highly prevalent among patients with familial premature coronary artery disease (FP-CAD). Whether these risk factors equally affect other family members remains unknown. Methods We examined 222 FP-CAD patients, 158 unaffected sibs, 197 offspring and 94 spouses in 108 FP-CAD families (≥2 sibs having survived CAD diagnosed before age 51 (M)/56 (F)), and compared them to population controls. Results Unaffected sibs had a higher prevalence of hypertension (49% versus 24%, p < 0.001), hypercholesterolemia (47% versus 34%, p = 0.002), abdominal obesity (35% versus 24%, p = 0.006) and smoking (39% versus 24%, p = 0.001) than population controls. Offspring had a higher prevalence of hypertension (females), hypercholesterolemia and abdominal obesity than population controls. No difference was observed between spouses and controls. Compared to unaffected sibs, FP-CAD affected sibs had a similar risk factor profile, except for smoking, which was more prevalent (76% versus 39%, p = 0.008). Conclusions Hypertension, obesity and hypercholesterolemia are highly prevalent among first-degree relatives, but not spouses, of patients with FP-CAD. These persons deserve special medical attention due to their familial/genetic susceptibility to atherogenic metabolic abnormalities. In these families, smoking may be the trigger for FP-CAD.

Diabetes mellitus type 1 prevention in the State of Tamaulipas (Mexico): Phase 1 identification of immunogenetic risk factors in first-degree relatives

Diabetes mellitus type 1 prevention in the State of Tamaulipas (Mexico): Phase 1 identification of immunogenetic risk factors in first-degree relatives