BMJ  2007;335:481-485 (8 September), doi:10.1136/bmj.39253.577859.BE

Analysis

Families of patients with premature coronary heart disease: an obvious but neglected target for primary prevention

C K Chow, cardiology research fellow1, A C H Pell, consultant cardiologist2, A Walker, health economist3, C O'Dowd, health economist3, A F Dominiczak, professor of cardiovascular medicine1, J P Pell, professor of epidemiology1

1 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, 2 Monklands Hospital, Airdrie, 3 Robertson Centre for Biostatistics, University of Glasgow

Correspondence to: J Pell j.pell@clinmed.gla.ac.uk

Risk of premature coronary heart disease is increased in the families of affected patients. C K Chow and colleagues argue that targeting relatives for primary prevention would be an effective policy

The first 150 words of the full text of this article appear below.


  • Prevention of coronary heart disease is most effective if targeted at people with high overall risk
  • First degree relatives of patients with premature myocardial infarction have double the risk of the condition
  • In the UK, about 20% of all admissions for myocardial infarction occur in patients with premature myocardial infarction
  • More than a third of admissions for premature myocardial infarction could be prevented by screening and treating first degree relatives


First degree relatives of patients with premature coronary heart disease are at increased risk of the disease. Compared with the general population, siblings have at least double the risk, because of shared lifestyle risk factors and genetic predisposition. Offspring and partners are also at increased risk. Relatives have an increased prevalence of modifiable risk factors including hypertension, dyslipidaemia, and smoking. Some guidelines recommend screening of relatives, but surveys indicate that this does not occur in practice. We propose that first . . . [Full text of this article]


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This article has been cited by other articles:

  • Di Castelnuovo, A., Quacquaruccio, G., Donati, M. B., de Gaetano, G., Iacoviello, L. (2009). Spousal Concordance for Major Coronary Risk Factors: A Systematic Review and Meta-Analysis. Am J Epidemiol 169: 1-8 [Abstract] [Full text]  
  • Marshall, T. P (2007). Risk factors inform screening. BMJ 335: 577-577 [Full text]  

Rapid Responses:

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A more obvious target for cardiovascular prevention
Tom P Marshall
bmj.com, 7 Sep 2007 [Full text]
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