1 Office of Minority Health and Health Equity Centers for Disease Control and Prevention Atlanta GA.
2 Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion Atlanta GA.
J Am Heart Assoc. 2019 Jul 16;8(14):e012364. doi: 10.1161/JAHA.119.012364. Epub 2019 Jul 13.
Background Because family history is a known risk factor for heart disease, it is important to characterize its public health impact in terms of population prevalence of family history of heart disease, the burden of heart disease attributable to family history, and whether family history interacts with modifiable risk factors for heart disease. Methods and Results We used population data from NHANES (the National Health and Nutrition Examination Survey [2007-2014]) to measure the association of self-reported family history of premature heart disease ( FHPHD ) with cardiovascular disease (n=19 253) and to examine the association between cardiovascular health metrics and FHPHD (n=16 248). Using logistic regression and multivariable adjustment, family history odds ratios were 5.91 (95% CI , 3.34-10.44) for ages 20 to 39, 3.02 (95% CI, 2.41-3.79) for ages 40 to 59, and 1.87 (95% CI , 1.54-2.28) for age ≥60 for cardiovascular disease. The prevalence of cardiovascular disease for the population with a FHPHD (15.72%; 95% CI , 13.81-17.64) was more than double the prevalence of cardiovascular disease for those without a family history (6.25%; 95% CI , 5.82-6.69). Compared with participants with optimum cardiovascular health, the prevalence ratio for FHPHD was 1.98 (95% CI , 1.40-2.79) for those with inadequate cardiovascular health. Conclusions Millions of people who are at high risk of having cardiovascular disease could be identified using FHPHD . FHPHD can become an important component of public health campaigns that address modifiable risk factors that plan to reduce the overall risk of heart disease.
由于家族史是心脏病的已知危险因素,因此重要的是要根据心脏病家族史的人群流行率、归因于家族史的心脏病负担以及家族史是否与可改变的心脏病危险因素相互作用来描述其公共卫生影响。
我们使用 NHANES(国家健康和营养检查调查[2007-2014])中的人群数据来衡量自我报告的早发性心脏病家族史(FHPHD)与心血管疾病(n=19253)之间的关联,并检查心血管健康指标与 FHPHD 之间的关联(n=16248)。使用逻辑回归和多变量调整,FHPHD 的家族史比值比为 20-39 岁为 5.91(95%CI,3.34-10.44),40-59 岁为 3.02(95%CI,2.41-3.79),年龄≥60 岁为 1.87(95%CI,1.54-2.28)。患有 FHPHD 的人群的心血管疾病患病率(15.72%;95%CI,13.81-17.64)是没有家族史的人群的两倍多(6.25%;95%CI,5.82-6.69)。与心血管健康状况最佳的参与者相比,心血管健康状况不佳且 FHPHD 的流行率比为 1.98(95%CI,1.40-2.79)。
数以百万计的患有心血管疾病高风险的人可以通过 FHPHD 识别出来。FHPHD 可以成为公共卫生运动的重要组成部分,这些运动旨在解决可改变的风险因素,以降低心脏病的整体风险。