40% Of Premature Heart Attacks May Be Prevented By Screening Family Members

Editor's Choice
Main Category: Cardiovascular / Cardiology
Also Included In: Primary Care / General Practice
Article Date: 08 Sep 2007 - 0:00 PST


If all middle-aged adults who had a family history of coronary heart disease were screened perhaps 40% or more of all premature heart attacks could be avoided, according to a report published in the The British Medical Journal (BMJ).

According to scientists at the University of Glasgow, Scotland, family members of patients who have premature CHD (coronary heart disease) are at a much higher risk of developing the same disease. The researchers examined data from previous studies.

If a middle-aged person has premature CHD his/her sibling runs twice the risk of developing the same, compared to a person whose sibling is healthy, say the authors. Another person at higher risk is the patient's partner - the reason being that a partner most likely shares risk factors in his/her lifestyle with the patient.

If more than one family member has (had) premature CHD the risk for the rest of the family is greater still. The authors say that family history can identify an enormous number of people who are at overall risk of developing CHD.

The writers cite a previous study which showed that 14% of families with a history of CHD accounted for nearly half of all CHD events and nearly three-quarters of premature deaths.

By extrapolating from data gleaned from previous studies, the authors say that at least 6,485 heart attacks could be prevented in England and Scotland each year. They believe that screening middle aged adults with a family history of CHD may prevent 42% of premature heart attacks and 8% of all heart attacks.

There is a lot a patient can do to alter his/her risk. This includes giving up smoking, taking measures to regulate blood pressure, eating more carefully, taking exercise and sleeping adequately - as well as receiving other medical treatments. The writers argue that siblings and other family members would gain from effective interventions to lower the risks.

Rather than trying to identify high risk families via school, place of work, or with questionnaires through the internet, the authors say "wide coverage could be achieved by identifying relatives whenever someone is admitted to hospital for premature heart attack. Furthermore they may be motivated by their relative's illness, thereby improving the attainment and maintenance of risk factor control."

CHD patients are usually presented acutely to A&E (accident and emergency department of a hospital, ER in the USA), or they are referred to an outpatient clinic. They could be identified at those points and family members could be invited in for screening, the authors write.

The researchers conclude that the patient's immediate family is an obvious group at which primary prevention should be targeted, rather than neglected.

"Families of patients with premature coronary heart disease: an obvious but neglected target for primary prevention"
C K Chow, A C H Pell, A Walker, C O'Dowd, A F Dominiczak, and J P Pell
BMJ Volume 335, pp 481-5
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Written by: Christian Nordqvist
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