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Family ties and heart disease.

Family ties and heart disease

People with two immediate familymembers who suffer a heart attack before age 55 are at five to 10 times the risk of contracting early heart disease themselves compared with people with no such occurrences in their immediate family. And three-quarters of people whose heart disease can be linked to a genetic predisposition have a second, potentially avoidable, risk factor.

These findings come from what isapparently the largest study to date of the inheritance of heart disease in the United States -- a compilation of family histories for more than 94,000 people in Utah. The data are being collected and analyzed by Roger R. Williams and his colleagues at the University of Utah in Salt Lake City. Williams discussed the study at the recent American Heart Association Science Writers Forum in Monterey, Calif.

While other work, such as the ongoingstudy of residents of Framingham, Mass., has established a positive family history as a risk factor in heart disease, these studies have not gone back more than one or two generations, so the relationship has not been well quantified.

Williams has a prime opportunity toinvestigate the inheritance of heart disease, says Peter W. F. Wilson of the Framingham study, because the Mormon families that make up the bulk of the Utah study tend to be large, close-knit and available for long-term follow-up. But lifestyle differences such as abstention from alcohol may limit generalizations from the data, Wilson says.

Williams had Utah high school studentsdetail their family health history going back two generations. The researchers verified the process by directly interviewing a sampling of participating families and checking hospital and physician records.

In addition to the five- to 10-foldincrease in risk among families with more than two members suffering early heart disease, Williams and his colleagues found that in 75 percent of these families a second factor -- high blood pressure, high cholesterol or smoking--appeared to spark the process. As an example, he pointed to a family in which 12 members had heart attacks before age 45. While one or two had high blood pressure and one or two had high cholesterol, all of them had smoked. "It would appear the mechanism leading to early heart attacks in this family is an inherited predisposition to something--we don't know what--that is triggered by smoking," he says.

Since the second factor can often bereversed by behavior changes or drugs, the finding underlines the need for cardiologists to counsel family members of people with heart disease to control their own risk factors, Williams says.

The family history study sets up anepidemiologic correlation between genetics and early heart disease. Williams is now looking at several inheritable factors, including changes in apolipoprotein-B (see p.90), to determine whether they are specifically responsible.
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Title Annotation:genetic aspects of heart disease
Author:Silberner, Joanne
Publication:Science News
Date:Feb 7, 1987
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