Rissanen A M
Am J Cardiol. 1979 Jul;44(1):60-6. doi: 10.1016/0002-9149(79)90251-0.
The occurrence of coronary heart disease and its main risk factors were assessed among the first degree relatives of 309 men from South and East Finland, including 203 men with fatal or nonfatal myocardial infarction and 106 healthy reference men under age 56 years. The younger the patient at the diagnosis of a first myocardial infarction, the more common was coronary heart disease in his parents and siblings. The risk of having coronary heart disease by age 55 was, respectively, 11.4, 8.3 and 1.3 times greater in the South and 6.7, 3.6 and 1.8 times greater in the East for the brothers of patients than for the brothers of reference subjects depending on whether the diagnosis of myocardial infarction in the patient had first been established before the age of 46 years of age 46 to 50 years or at age 51 to 55 years. Hypertension and hyperlipidemia, but none of the other risk factors studied, were most common among the relatives of the youngest patients and diminished in frequency with advancing age of the patient. Most of the strong familial component in coronary heart disease of early onset thus appears to be mediated by familial hyperlipidemias and hypertension. It is suggested that the risk of premature coronary heart disease in the persons at highest risk could be largely eliminated if information about family history were used to identify such persons at an early stage and if they were treated properly for their correctable risk factors.
在来自芬兰南部和东部的309名男性的一级亲属中评估了冠心病的发生情况及其主要危险因素，其中包括203名患有致命性或非致命性心肌梗死的男性以及106名年龄在56岁以下的健康对照男性。首次心肌梗死诊断时患者年龄越小，其父母和兄弟姐妹中患冠心病的情况就越常见。根据患者首次心肌梗死诊断是在46岁之前、46至50岁还是51至55岁，患者的兄弟在55岁时患冠心病的风险，在南部分别比对照对象的兄弟高11.4倍、8.3倍和1.3倍，在东部分别高6.7倍、3.6倍和1.8倍。高血压和高脂血症，而非所研究的其他危险因素，在最年轻患者的亲属中最为常见，且随着患者年龄的增长频率降低。因此，早发性冠心病中大多数强大的家族性成分似乎是由家族性高脂血症和高血压介导的。有人提出，如果利用家族史信息在早期识别出高危人群，并对其可纠正的危险因素进行适当治疗，那么高危人群中过早患冠心病的风险在很大程度上是可以消除的。
