Parental Cardiovascular Disease as a Risk Factor for Cardiovascular Disease in Middle-aged Adults

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Abstract
An offspring report of a positive parental history of cardiovascular disease (CVD), particularly if premature at onset, is a widely accepted risk factor for offspring cardiovascular events. Current guidelines1,2 recommend consideration of a positive parental history of premature coronary heart disease when deciding whether to initiate antihyperlipidemic or antihypertensive therapy for primary prevention. However, the true magnitude of independent risk that is conferred by the occurrence of parental CVD remains controversial. This uncertainty exists in large part because available data examining the association between parental and offspring CVD are derived from retrospective case-control studies3-7 or longitudinal studies8-20 relying on offspring self-report, with limited or absent validation of parental events. Offspring report of parental history may be highly unreliable,21-25 in part due to recall bias, and may lead to inflated estimates of risk associated with parental CVD. The effect of parental CVD on offspring risk across strata of individual risk factors is also not well understood.