Kavanagh T, Shephard R J, Hamm L F, Mertens D J, Thacker L
Toronto Rehabilitation Centre, Cardiac Rehabilitation and Secondary Prevention Program, ON.
J Cardiopulm Rehabil. 2000 May-Jun;20(3):172-9. doi: 10.1097/00008483-200005000-00005.
The offspring of parents who suffer from premature coronary heart disease have a significantly higher risk of early cardiac death than controls. A genetic predisposition is compounded by a commonality of environmental risk factors within families. Increasing awareness, early detection and modification of risk factors are essential components of an effective public health strategy to protect this highly vulnerable population.
The sons (n = 571) of parents with premature coronary heart disease attended the Toronto Rehabilitation Centre for a risk factor evaluation that included an interview with questionnaire, measurement of body dimensions and blood lipids, and cardiopulmonary exercise testing. A follow-up questionnaire was sent out 2 years after the evaluation.
Despite concern about family history, 23% of subjects were smokers and 75% were inactive. Objective data confirmed a substantial prevalence of cardiac risk factors: less than optimal cardiovascular fitness (48%), overweight (34%), total cholesterol > or = 200 mg/dL (46%), high-density lipoprotein cholesterol < or = 35 mg/dL (26%), low-density lipoprotein cholesterol > or = 160 mg/dL (16%), triglycerides > or = 200 mg/dL (27%), and lipoprotein (a) > 30 mg/dL (24%). Although almost all had a family physician whom they had seen an average of 1.8 times in the past year, and 4.7 times in the previous 3 years, screening and risk factor intervention strategies were disappointing. Two-year follow-up data showed a heightened health awareness, with a greater proportion of subjects exercising and attempting to maintain an appropriate body mass.
The male offspring of parents who have suffered a premature coronary event exhibit a substantial prevalence of modifiable risk factors. The family physician can play an essential role in promoting a healthy lifestyle through risk reduction counselling and screening.
