PARENTAL HISTORY IS AN INDEPENDENT RISK FACTOR FOR CORONARY-ARTERY DISEASE - THE FRAMINGHAM-STUDY
PARENTAL HISTORY IS AN INDEPENDENT RISK FACTOR FOR CORONARY-ARTERY DISEASE - THE FRAMINGHAM-STUDY
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DOI：
10.1016/0002-8703(90)90216-k
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发表时间：
1990-10-01
影响因子：
4.8
通讯作者：
KANNEL, WB
中科院分区：
文献类型：
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作者：
MYERS, RH;KIELY, DK;KANNEL, WB
在弗雷明翰研究的5209名参与者中，在控制了标准危险因素和随访时间的Logistic回归模型中，CAD家族史(CAD定义为父母死亡)被发现是CAD的重要独立预测因素。有阳性父母病史的人患冠心病的风险增加29%，父母病史与冠心病之间的关联强度与其他标准风险因素，如收缩压、胆固醇水平和吸烟的相关性相似。没有证据表明，有冠心病家族史的人应对已知危险因素的有害影响的能力降低；也就是说，没有发现任何危险因素与父母冠心病病史之间存在显著的交互作用。在风险因素分析显示冠心病风险较低的男性中(即不吸烟、瘦、非高血压者)，有过冠心病经历的人中，超过三分之二的人有积极的父母病史。这项研究表明，在被标准风险因素预测为低风险的人中，冠心病可能有很大的遗传成分，而与父母病史相关的风险可能不会通过修改这些因素而降低。然而，在有阳性家族史的人中，那些有良好风险特征的人比那些风险特征不好的人患冠心病的风险要低得多。
Family history of CAD, defined as parental death by CAD, was found to be a significant independent predictor of CAD in a logistic regression model controlling for standard risk factors and length of follow-up among the 5209 participants in the Framingham Study. Persons with a positive parental history have a 29% increased risk of CAD, and the strength of the association between parental history and CAD is similar to that found for other standard risk factors such as systolic blood pressure, cholesterol level, and cigarette smoking. No evidence was found that persons with a family history of CAD have a decreased capacity to cope with the deleterious effects of known risk factors; that is, no significant interaction was found between any of the risk factors and parental history of CAD. Among men with low risk for CAD by risk-factor profile (i.e., nonsmoking, thin, nonhypertensive persons), more than two thirds of those who experience CAD have a positive parental history. This study suggests that CAD among persons who are predicted to be a low risk by standard risk factors may have a substantial genetic component and that the risk associated with parental history may not be reduced by modification of these factors. Nevertheless, among persons with a positive family history, those with a favorable risk profile are at substantially less risk for CAD than those with an unfavorable risk profile.