Family history : an independent risk factor for coronary heart disease ( CHD )

• family history is considered to be significant when a male relative's first CHD event occurred before the age of 55, or a female relative's first CHD event occurred before 65
  • twin studies have shown that death from CHD is largely influenced by genetic factors - with a positive family history being associated with a 75% increase in risk in men, and an 84% increase in women
  • in men a paternal history of CHD increases their risk to 1.4 and to 1.85 when both parents are affected
  • women in whom both parents had CHD are at a still higher risk (2.05)
• NICE state that (2):
  • estimated CVD risk should be increased by a factor of 1.5 in people with a first-degree relative with a history of premature CHD (age at onset younger than 55 in fathers, sons or brothers or younger than 65 in mothers, daughters or sisters)
  • estimated CVD risk should be increased by a factor of between 1.5 and 2.0 if more than one first-degree relative has a history of premature CHD

Reference:

1. British Heart Foundation (Factfile 11/2003). Family History of Coronary Heart Disease in Primary Care.
2. NICE. Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline NG238. Published December 2023