Sibling history of myocardial infarction or stroke and risk of cardiovascular disease in the elderly: the Cardiovascular Health Study

Abstract

Purpose: To assess the relationship between sibling history of myocardial infarction (MI) or stroke with cardiovascular disease (CVD) and risk factors in older adults.

Methods: Prospective cohort study of 5,888 older adults participating in the Cardiovascular Health Study (CHS). History of MI and stroke in siblings was obtained by self-report. Participants with positive sibling histories were compared to those with negative histories to determine if prevalent or incident disease (coronary heart disease [CHD], MI, stroke, angina), subclinical CVD (carotid wall thickness, left ventricular mass, hypertension, diabetes, ankle-brachial index), CVD risk factors differed between groups.

Results: More than 91% (n = 5,383) of CHS participants reported at least one sibling. Sibling history of MI was associated with increased disease prevalence (CHD, MI, angina) and incidence (CHD, angina). Sibling history of stroke was associated with increased disease prevalence (CHD, angina). Sibling history of either MI or stroke was associated with increased disease prevalence and incidence for CHD, MI and angina, more subclinical disease, and a higher CVD risk profile.

Conclusions: Sibling history of MI and stroke were markers of higher CVD risk status even in older adults. Of clinical importance, participants with positive sibling history have numerous risk factors amenable to intervention.

Figure 1

Odds ratios of prevalent outcomes and sibling history of mi or sibling history of stroke. The size of the rectangles is proportional to the reciprocal of the variance of the odds ratio. *Adjusted analyses include age, gender, black race, IMT of common & internal carotid arteries, ECG LV mass, ankle-brachial index, fibrinogen, Factor VII, LDL & HDL cholesterols, body mass index, log insulin, log glucose, log creatinine, systolic blood pressure, diabetes, hypertension, medication use, aspirin use greater than two times per two weeks, ECG abnormalities. ^†Estimated standard errors are for log (OR) estimates.

Figure 2

Hazard ratios of incident outcomes and sibling history of mi or sibling history of stroke. the size of the rectangles is proportional to the reciprocal of the variance of the odds ratio. *Adjusted analyses include age, gender, black race, IMT of common & internal carotid arteries, ECG LV mass, ankle-brachial index, fibrinogen, Factor VII, LDL & HDL cholesterols, body mass index, log insulin, log glucose, log creatinine, systolic blood pressure, diabetes, hypertension, medication use, aspirin use greater than two times per two weeks, ECG abnormalities. ^†Estimated standard errors are for log (HR) estimates.