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Research ArticleOriginal Article

Family History and Premature Coronary Heart Disease

Charles B. Eaton, Andrew G. Bostom, Lisa Yanek, Joseph P. Laurino, William McQuade, Anne Hume and Jacob Selhub
The Journal of the American Board of Family Practice September 1996, 9 (5) 312-318; DOI: https://doi.org/10.3122/jabfm.9.5.312
Charles B. Eaton
MD
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Andrew G. Bostom
MD
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Lisa Yanek
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Joseph P. Laurino
PhD
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William McQuade
MPH
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Anne Hume
PharmD
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Jacob Selhub
PhD
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Abstract

Background: We were interested in studying whether a family history of coronary heart disease (CHD) persisted as a significant risk factor for premature coronary heart disease after adjusting for traditional and nontraditional risk factors.

Methods: Ninety-five case patients with documented premature CHD (occurring in a person less than 60 years old and with greater than 50 percent occlusion of a major epicardial vessel or a documented myocardial infarction) and 95 community-based control patients were examined for risk factors including family history, hypertension, diabetes mellitus, sedentary lifestyle, smoking, body mass index, total cholesterol, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, lipoprotein(a), homocysteine, and fibrinogen.

Results: The risk of premature CHD for a positive family history ranged from an odds ratio (OR) of 3.25 for a standard family history of CHD in a first-degree relative, 5.9 for family history of early CHD in a first-degree relative before the age of 45 years, and 6.1 for a strong family history of CHD defined as CHD in at least two first-degree relatives. Family history persisted as a significant risk factor for premature CHD (OR = 3.9, 95 percent confidence interval [CI] 1.8-8.7) in multiple variable models that included traditional and nontraditional risk factors. It was rare, however, for a person with a positive family history not to have at least two other traditional or nontraditional risk factors.

Conclusions: Family history of CHD should not be considered a simple binary risk factor for premature CHD, and a positive family history of CHD indicates that a person is at high risk for premature CHD independent of traditional and nontraditional risk factors.

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The Journal of the American Board of Family     Practice: 9 (5)
The Journal of the American Board of Family Practice
Vol. 9, Issue 5
1 Sep 1996
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Family History and Premature Coronary Heart Disease
Charles B. Eaton, Andrew G. Bostom, Lisa Yanek, Joseph P. Laurino, William McQuade, Anne Hume, Jacob Selhub
The Journal of the American Board of Family Practice Sep 1996, 9 (5) 312-318; DOI: 10.3122/jabfm.9.5.312

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Family History and Premature Coronary Heart Disease
Charles B. Eaton, Andrew G. Bostom, Lisa Yanek, Joseph P. Laurino, William McQuade, Anne Hume, Jacob Selhub
The Journal of the American Board of Family Practice Sep 1996, 9 (5) 312-318; DOI: 10.3122/jabfm.9.5.312
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