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.