Parental history of premature coronary heart disease mortality and signs of ischemi on the resting electrocardiogram

OBJECTIVES Here we explore the association between family history of premature coronary heart disease (CHD) death and ischemic electrocardiogram (ECG) findings in the offspring. BACKGROUND In the general population, signs of ischemi are found on the resting ECG in about 10% of middle-aged men and women. Their independent predictive value for CHD morbidity and mortality has been shown in several studies. METHODS Our results are based on cross-sectional dat from three large epidemiological studies performed in Belgium during the past two decades: the Belgian Heart Disease Prevention Project (n = 8,145), the Belgian Interuniversity Research on Nutrition and Health survey (n = 7,625) and the MONIC project (n = 3,193). parental history of fatal CHD was considered premature if the father died from CHD before age 60 or the mother before age 70. Ischemic ECG findings were defined according to Minnesot Code criteri I1–3, IV1–3, V1–3 or VII1. RESULTS Subjects with parental history of premature CHD death were found to have experienced significantly more frequently symptomatic CHD. After exclusion of symptomatic individuals, no major differences in lifestyle-related risk factors were found between the groups with and without parental history of premature fatal CHD. After multivariate adjustment for age, smoking, body mass index and sex, the odds ratios (and 95% confidence interval [CI]) for ECG ischemi associated with positive parental history of premature death were 1.42 (1.10–1.82), 1.47 (1.16–1.88) and 1.37 (0.78–2.41) in the three studies. Additional adjustment for systolic blood pressure, total cholesterol and, if available, lifestyle-related factors did not alter the magnitude of the odds ratios. Overall, in men aged 45 to 64 years, ECG ischemi was significantly more frequent (36% excess) in those with positive parental history. CONCLUSIONS Subjects in whom one or both parents died prematurely from cardiac-related diseases have signs of ischemi more frequently on their electrocardiogram, and this is independent of other risk factors.