Association between parental age at onset of CVD and offspring age at onset of CVD: Application to Framingham Study

OBJECTIVE: The risk for cardiovascular disease (CVD) is higher for individuals with a family history of premature CVD (threshold of age 55 years for males, 65 years for females). However, little is known about the effect that each unit increase or decrease of parental age of onset of CVD has on offspring age of onset of CVD. I tested the hypothesis that there is an association between parental age of onset of CVD and offspring age of onset of CVD. METHODS: The Framingham Heart Study data was used for analysis. Conditional imputation for CVD-censored parental age (i.e., parents that didn’t experience onset of CVD) was performed. Cox proportional regression analysis was performed, with offspring’s age of onset of CVD as the dependent variable and parental age of onset of CVD as the primary predictor. Modifiable risk factors in offspring, such as cigarette smoking, beer intake, BMI, systolic blood pressure (SBP), diabetes mellitus, high-density lipoprotein (HDL) level, and hypercholesterolemia were controlled for in the analysis. RESULTS: Parental age of onset of CVD was predictive of offspring age of onset of CVD (HR=0.968; P\u3c.0001; N=2622). Offspring with a parent with late onset CVD were less likely to have early onset CVD than offspring with a parent with early onset. Cigarette smoking, beer intake, and HDL were determined to be associated confounding variables and were found to be significant risk factors. CONCLUSIONS: Offspring age of onset of CVD is significantly associated with parental age of onset of CVD. The incorporation of the parameter, parental age of onset of CVD, into risk estimate calculators may improve accuracy of identification of high-risk patients in clinical settings

Kaplan-Meier Survival Estimates.

<p>Kaplan-Meier Survival Estimates.</p

Survival analysis for the association between maternal age at onset of CVD and offspring age at onset of CVD.

<p>Survival analysis for the association between maternal age at onset of CVD and offspring age at onset of CVD.</p

Baseline characteristics of offspring based on paternal and offspring associations.

<p>Baseline characteristics of offspring based on paternal and offspring associations.</p

Baseline characteristics of offspring based on maternal and offspring associations.

<p>Baseline characteristics of offspring based on maternal and offspring associations.</p

Parental Age of Onset of Cardiovascular Disease as a Predictor for Offspring Age of Onset of Cardiovascular Disease - Fig 2

<p>A, Correlation of maternal age of onset of CVD and offspring age at onset of CVD with fixed smoking status. B, Correlation of paternal age of onset of CVD and offspring age at onset of CVD with fixed smoking status.</p