同胞心肌梗死或中风史与老年人心血管疾病风险：心血管健康研究。
Sibling history of myocardial infarction or stroke and risk of cardiovascular disease in the elderly: the Cardiovascular Health Study.
机构信息
Department of Biostatistics, Box 357232, 1959 NE Pacific St, University of Washington, Seattle, WA 98195, USA.
出版信息
Ann Epidemiol. 2009 Dec;19(12):858-66. doi: 10.1016/j.annepidem.2009.07.095.
PURPOSE
To assess the relationship between sibling history of myocardial infarction (MI) or stroke with cardiovascular disease (CVD) and risk factors in older adults.
METHODS
Prospective cohort study of 5,888 older adults participating in the Cardiovascular Health Study (CHS). History of MI and stroke in siblings was obtained by self-report. Participants with positive sibling histories were compared to those with negative histories to determine if prevalent or incident disease (coronary heart disease [CHD], MI, stroke, angina), subclinical CVD (carotid wall thickness, left ventricular mass, hypertension, diabetes, ankle-brachial index), CVD risk factors differed between groups.
RESULTS
More than 91% (n = 5,383) of CHS participants reported at least one sibling. Sibling history of MI was associated with increased disease prevalence (CHD, MI, angina) and incidence (CHD, angina). Sibling history of stroke was associated with increased disease prevalence (CHD, angina). Sibling history of either MI or stroke was associated with increased disease prevalence and incidence for CHD, MI and angina, more subclinical disease, and a higher CVD risk profile.
CONCLUSIONS
Sibling history of MI and stroke were markers of higher CVD risk status even in older adults. Of clinical importance, participants with positive sibling history have numerous risk factors amenable to intervention.
目的
评估兄弟姐妹中曾患有心肌梗死（MI）或中风与老年人心血管疾病（CVD）及相关风险因素的关系。
方法
这是一项针对 5888 名参与心血管健康研究（CHS）的老年人的前瞻性队列研究。通过自我报告的方式获取兄弟姐妹中 MI 和中风的病史。将有阳性家族史的参与者与有阴性家族史的参与者进行比较，以确定是否存在现患或新发疾病（冠心病[CHD]、MI、中风、心绞痛）、亚临床 CVD（颈动脉壁厚度、左心室质量、高血压、糖尿病、踝臂指数）以及两组之间的 CVD 风险因素是否存在差异。
结果
超过 91%（n=5383）的 CHS 参与者报告至少有一个兄弟姐妹。MI 家族史与疾病的患病率（CHD、MI、心绞痛）和发病率（CHD、心绞痛）增加相关。中风家族史与疾病的患病率（CHD、心绞痛）增加相关。MI 或中风的家族史与 CHD、MI 和心绞痛的患病率和发病率增加、更多的亚临床疾病以及更高的 CVD 风险特征相关。
结论
即使在老年人中，MI 和中风的家族史也是 CVD 风险状态较高的标志物。具有阳性家族史的参与者存在许多可干预的风险因素，这具有重要的临床意义。
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