[Familial cardiovascular risk factors].

In a 16 per cent systematic sample of the fifth grade elementary school pupils from Split, Yugoslavia (198 boys and 250 girls, aged 11.3 +/- 0.4 years; mean +/- SD), 116 children (25,9% of the sample; 61 girls and 55 boys) were found at risk for cardiovascular diseases, having the values of one or more of the recognized risk factors above the 90th percentile of distribution for age and sex, e.g. serum cholesterol greater than 5.6 mmol/l. After the 3-year follow-up period the parents and the available relatives of these children were checked for the same risk factors in order to evaluate the magnitude of family aggregation. The prevalence of cardiovascular risk factors was 3-5 times higher for the parents of the children at risk than for the control parents (e.g. 57.1 vs 11.8 per cent in boys; p less than 0.001). The observed parent-child agreement was highest for serum cholesterol and triglycerides (range 30.0-37.5%; p less than 0.01). The family clustering of risk factors was prominent in the second generation (e.g. grandparents, p less than 0.01) as well, and even among the other relatives (p less than 0.05). It is concluded that the probability of adverse cardiovascular outcome increases not only with the individual level of aberration and with the mutual enhancement of risk factors, but with positive history and family aggregation as well: these phenomena have important influence on the process of physicians' decision making, with obvious practical implications.