Is A Positive Family History Of Cardiovascular Diseases Associated With Ideal Cardiovascular Health In The Community? The Polish Norwegian Study

Introduction: Self-reported family history of cardiovascular diseases (FHxCVD) is associated with an increased cardiovascular risk. In contrast to genetic profiling, FHxCVD has the advantage that it reflects not only genetic susceptibility, but also factors related to a shared environment and behaviors. Ideal cardiovascular health (ICVH) is a summary indicator of behavioral and major subsequent biological factors. FHxCVD is presumed to motivate the adoption of a healthy lifestyle, yet little evidence exists to support this hypothesis in a community setting. Hypothesis: We assessed the hypothesis that self-reported family history of cardiovascular diseases is associated with ICVH in a community based study. Methods: We used cross-sectional, baseline data of 10934 participants, age 45 to 64 years free of cardiovascular diseases in an ongoing cohort study (PONS). Data were collected through structured questionnaires and fasting blood samples. Ideal cardiovascular health was defined according to the American Heart Association criteria (7 metrics assessed at 3 levels: ideal, intermediate, and poor). FHxCVD was self-reported, based on three questions inquiring about coronary heart disease, stroke, hypertension in parents and siblings. We considered a positive FHxCVD if an affirmative answer to any of these three questions was reported. We used multivariable logistic models and adjusted for age, sex, education, place of residence, health care services. Results: The prevalence of poor CVH (0-2 ideal metrics) was 63% and of ideal CVH (6, 7 ideal metrics) was 0.07%. The prevalence of a positive FHxCVD was 77%. Mean (SD) for ICVH score was 2.20 (1.06), with no difference between those with positive and negative FHxCVD. A positive FHxCVD was associated with increased odds of a poor cardiovascular health (0-2 health components), OR (95%CI) 1.12 (1.01-1.23), after adjusting for age, sex, education, rural residence and health care services. Among participants with known history of hypertension, having a positive family history of HTN (but not of CHD or stroke) was associated with lower odds of having their blood pressure controlled (OR 0.83 , 95%CI 0.71-0.96), after multivariable adjustment. Conclusion: In this community-based study we found that self-reported FHxCVD is not accompanied by healthy behaviors. In spite of its personal value, simple knowledge of one’s FHxCVD may not suffice as motivator for lifestyle changes.