Bao W, Srinivasan S R, Wattigney W A, Berenson G S
Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, La.
Circulation. 1995 Jan 15;91(2):365-71. doi: 10.1161/01.cir.91.2.365.
Although cardiovascular risk factors relate to family history of cardiovascular disease, it is not clear how the relation changes from children to young adults.
As part of a community study for cardiovascular health, parental history of diseases was obtained from 8276 offspring 5 to 31 years old, 36% black and 64% white. Between 5- to 10-year-old children and 25- to 31-year-old young adults, prevalence of parental heart attack increased from 5% to 25%. More prevalent in blacks than in whites, parental stroke increased from 2% to 9% in whites versus 3% to 19% in blacks; parental diabetes rose from 7% to 19% in whites versus 9% to 33% in blacks; and parental hypertension increased from 26% to 59% in whites versus 40% to 72% in blacks. Offspring with parental heart attack history were significantly overweight after 10 years of age and showed elevated levels of total cholesterol, VLDL cholesterol, LDL cholesterol, insulin, and glucose after 17 years of age, irrespective of weight. Offspring of diabetic parents were significantly overweight, irrespective of age. They showed significant increases in levels of insulin, glucose, triglycerides, total cholesterol, VLDL cholesterol, and LDL cholesterol after age 24 years, independent of weight. Offspring of hypertensive parents displayed overweight regardless of age, higher levels of blood pressure after age 10 years, and elevations of triglycerides and VLDL cholesterol after age 24 years irrespective of weight. Analyzed by race and sex in young adults, parental heart attack related strongly to LDL cholesterol in the white offspring, especially white males, and to insulin in the black offspring. Parental diabetes showed a stronger association with overweight and glucose in black females. Also noted was the relation between parental hypertension and overweight in black females.
Parental history is an important surrogate measure for cardiovascular risk in the offspring. However, parental history information alone is not sufficient to designate younger children for selective screening for high cholesterol, because of the young age of parents.
尽管心血管危险因素与心血管疾病家族史相关，但尚不清楚这种关系从儿童到年轻成年人是如何变化的。
作为一项心血管健康社区研究的一部分，从8276名5至31岁的后代中获取了父母的疾病史，其中36%为黑人，64%为白人。在5至10岁的儿童和25至31岁的年轻成年人之间，父母心脏病发作的患病率从5%上升到了25%。父母中风在黑人中比在白人中更常见，白人中父母中风的患病率从2%上升到9%，而黑人中则从3%上升到19%；父母患糖尿病的比例在白人中从7%上升到19%，在黑人中从9%上升到33%；父母患高血压的比例在白人中从26%上升到59%，在黑人中从40%上升到72%。有父母心脏病发作史的后代在10岁后明显超重，在17岁后总胆固醇、极低密度脂蛋白胆固醇、低密度脂蛋白胆固醇、胰岛素和血糖水平升高，与体重无关。糖尿病父母的后代无论年龄大小都明显超重。他们在24岁后胰岛素、葡萄糖、甘油三酯、总胆固醇、极低密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平显著升高，与体重无关。高血压父母的后代无论年龄大小都超重，10岁后血压水平较高，24岁后甘油三酯和极低密度脂蛋白胆固醇升高，与体重无关。在年轻成年人中按种族和性别分析，父母心脏病发作与白人后代尤其是白人男性的低密度脂蛋白胆固醇以及黑人后代的胰岛素密切相关。父母患糖尿病与黑人女性的超重和血糖有更强的关联。还注意到父母患高血压与黑人女性超重之间的关系。
父母的病史是后代心血管风险的重要替代指标。然而，仅靠父母的病史信息不足以指定年幼的儿童进行高胆固醇的选择性筛查，因为父母年龄较轻。
