The count of family histories of vascular diseases is an independent determinant of subclinical and clinical atherosclerosis

AIM: In cardiovascular risk assessment, the family history (FH) of cardio, cerebral or peripheral vascular disease are often summarized under a generic FH definition which completely ignore the number of FH items at which an individual is actually exposed. Here we interrogated the dataset of the IMPROVE study to assess whether the count of FH items (FHcount) confers an additional risk over and above that provided by the generic FH definition. METHODS: 3711 individuals free of vascular events (median age 64.4 years; 48% men) were followed up for three years. The subject’s FH profile was determined by a face-to-face interviews. The presence of at least one first-degree family member affected by cardio, or cerebral or peripheral vascular diseases identified the subject as positive for the corresponding specific FH item. RESULTS: In the IMPROVE study, the 21.5%, the 50.8%, the 23.8% and the 3.9% of subjects were exposed to zero, one, two, or three FH items, respectively. C-IMTmean-max increased progressively accordingly to the FHcount. This trend was also significant (ptrend=0.003) after adjustment for VRFs which aggregate at the family level (i.e. dyslipidemia, hypertension and diabetes). By Cox analysis, the FHcount was an independent associate of vascular events (ptrend=0.05) with an hazard ratios (95% CI) for each change of FHcount category of 1.20 (1.00-1.45). Conclusions: The count of FH items is an independent risk factor for subclinical and clinical atherosclerosis which adds over and above the generic definition of family history of vascular disease.