Heart disease often connected to genetics

If your parents had coronary heart disease before age 60, the walls of your neck arteries are more likely to be thicker, putting you at higher risk of heart disease, too, researchers reported recently in Circulation: Journal of the American Heart Association.

Compared with people with no parental history of early-onset coronary heart disease (CHD), those with at least one parent who had a heart attack or other coronary event such as chest pain before age 60 had thicker walls in the large carotid arteries of the neck that lead to the brain, researchers found. Thicker carotid artery walls are associated with a greater degree of atherosclerotic plaque.

The study investigated the symptomless thickening of carotid arteries called subclinical atherosclerosis.

"Studies have shown that subclinical atherosclerosis, as assessed by increased thickness of the carotid artery wall, is directly predictive of an increased risk of heart attack or stroke," said principal investigator Christopher J. O’Donnell, M.D., M.P.H., associate director of the National Heart, Lung, and Blood Institute’s Framingham Heart Study.

The investigators studied a subset of men and women enrolled in the Framingham Offspring Study, a study of 5,124 offspring (and their spouses) of the original participants in the Framingham Heart Study.

In this analysis, the researchers studied 1,662 men and women, average age 57, whose biological parents were both in the original Framingham study. Between 1995 and 1998, the offspring underwent carotid ultrasound imaging to measure their carotid walls. This noninvasive imaging technique detects vascular disease before symptoms are present.

The study showed that at any age, the average vessel wall thickness of the internal carotid arteries was greater in people with at least one parent who developed CHD before age 60, compared with those without a parental history of early-onset CHD.

"The association holds true for both men and women and is significant even after adjustment for other strong risk factors for atherosclerosis such as high blood pressure and high cholesterol," said Thomas J. Wang, M.D., a Framingham Heart Study researcher and the study’s lead author.

"The findings add to multiple studies recognizing that parental history of coronary heart disease is a risk factor for clinical disease and should be taken seriously," Wang said. "These data support guidelines saying that more rigorous preventive measures should be undertaken if an individual has a family history of heart disease."