"The trouble with heart disease is that the first symptom is often hard to deal with - sudden death!"
Close relatives face higher risk of heart disease than was thought.
Having a close relative with coronary artery disease puts you at greater risk of the disease than previously thought, claims new research.
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A close look at the arteries of people who had a parent, brother or sister with the disease found half had early signs of the artery-blocking condition called arteriosclerosis, even though they had no symptoms of a problem, say University of Texas researchers.
Findings
"This is higher than we anticipated. These people did not rank high in other risk factors. It indicates that, as other risk factors become better controlled, then family history may become more prominent," says lead researcher Dr. K. Lance Gould, a professor of medicine at the Texas, USA school.
A family history of heart disease long has been associated with increased risk in close relatives, but that increase has been blamed on the presence of other risk factors like high cholesterol and high blood pressure.
Now, however, family history appears to be an important risk factor in its own right, Gould says.
"What he is saying is that family history is in the same high category of risk factors as smoking, high cholesterol and high blood pressure," says Dr. Richard A. Stein, a professor of medicine at the State University of New York Downstate Medical Centre in Brooklyn and a spokesman for the American Heart Association.
Warning
"If you have a family history of coronary artery disease, you should be under more careful surveillance, you should be sensitive to any symptoms of chest pain when you exercise and be very proactive with other modifiable risk factors," Stein says.
In his study, Gould looked at the arteries of 18 people with coronary artery blockage and 32 of their parents, brothers and sisters with no symptoms of heart disease.
He also looked at the arteries of 30 people with risk factors such as high blood cholesterol and high blood pressure but no family history or artery disease, and the arteries of another 10 people with no family history and no risk factors.
The method used - positron emission topography (PET) scanning - is "probably the most sensitive methodology for detecting abnormalities in blood flow," Stein says.
The PET scans were done after the participants took a drug that simulates the kind of stress that increases blood flow in the heart muscle.
Gould found abnormal blood flow in half the symptom-free people with a family history of heart disease. Their abnormalities, caused by early signs of artery blockage, were similar to those of the participants who had known risk factors but no family history of heart disease, the study says. And both groups scored worse than those with no risk factors and no family history.
Gould says the findings should be comforting rather than scary for close relatives of heart disease patients, because effective preventive measures are readily available.
Prevention
"With modern pharmacology and our knowledge about diet and physical activity, the ability to prevent heart disease is great. From an individual point of view, it says you should not be lukewarm about eating better, losing weight and not smoking. Prevention is no longer a vague, general goal but rather something very personal," he says.
"To simply ignore a family history of heart disease would be a high-risk attitude," Gould says.
What To Do
Anyone with a family history of heart disease, such as a heart attack in a close male relative under age 55 or a close female relative under age 65, should take measures to reduce their risk, experts say.
"The trouble with heart disease is that the first symptom is often hard to deal with - sudden death!"
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