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Multicenter Study
. 2009 Nov;25(8):725-32.
doi: 10.1002/dmrr.1010.

Family history of myocardial infarction predicts incident coronary heart disease in postmenopausal women with diabetes: the Women's Health Initiative Observational Study

Rongling Li  1 , Mary J O'Sullivan, Jennifer Robinson, Monika M Safford, David Curb, Karen C Johnson
Affiliations
Multicenter Study

Family history of myocardial infarction predicts incident coronary heart disease in postmenopausal women with diabetes: the Women's Health Initiative Observational Study

Rongling Li et al. Diabetes Metab Res Rev. 2009 Nov.

Abstract

Background: Diabetes is a risk factor for coronary heart disease (CHD) but CHD does not occur in all diabetic individuals. The goal of this study was to assess the relationship between family history of myocardial infarction (MI) and incident CHD in diabetic postmenopausal women.

Methods: We conducted a prospective cohort study among 2642 diabetic postmenopausal women without CHD at baseline in the Women's Health Initiative Observational Study. Family history was defined as a proband report of MI in first-degree relatives. Incident CHD was defined as non-fatal MI, coronary revascularization, or CHD death.

Results: During 7.3 ( +/- 1.8) years of follow-up, 14.3% of the participants had incident CHD. The risk of incident CHD was 50% higher (HR = 1.50, 95% CI: 1.20-1.87, p = 0.0003) in those with a family history of an MI in at least one first-degree relative, and 79% higher (HR = 1.79, 95% CI: 1.36-2.35, P < 0.0001) if two or more first-degree relatives had an MI, compared to participants without a family history, after adjustment for covariates. The CHD risk increased with elevated systolic blood pressure (SBP) (HR = 1.01, 95% CI: 1.003-1.02, p = 0.001) but decreased with elevated diastolic BP (HR = 0.98, 95% CI: 0.97-0.999, p = 0.005) and with two or more episodes per week of physical activity (HR = 0.70, 95% CI: 0.52-0.93, p = 0.02).

Conclusions: The results suggest that a family history of MI predicts CHD in diabetic postmenopausal women. Close attention should be paid to BP control and physical activity in these women.

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Conflict of interest statement

Conflict of interest

None declared.

Figures

Figure 1
Figure 1
A sub-cohort of treated diabetic patients selected from the Women’s Health Initiative Observational Study (WHI-OS) at baseline
Figure 2
Figure 2
Survivals function of free of incident coronary heart disease (CHD) in diabetic patients during follow-up stratified by myocardial infarction (MI) in first-degree relatives. Log-rank test for strata homogeneity: P = −0.0002 for Figure 2A and P = −0.004 for Figure 2B
See this image and copyright information in PMC

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