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Early-Onset CAD In Parents Puts Kids At Higher Risk
NEW YORK, NY -- December 2, 1997 -- Children whose parents had onset of coronary artery disease (CAD) at a relatively young age were typically overweight beginning in childhood and developed additional risk factors for coronary heart disease as they matured into young adulthood, according to an article in tomorrow’s issue of The Journal of the American Medical Association (JAMA).
Gerald Berenson, M.D., and colleagues from the Tulane Center for Cardiovascular Health at Tulane School of Public Health and Tropical Medicine in New Orleans, LA., conducted a longitudinal study of children in semirural Bogalusa, LA. The authors examined the association between clinically-verified CAD among parents (the average age of first cardiac event was 50 for fathers and 52 for mothers) and the change in CAD risk factor profiles for their offspring as they grew from childhood into young adulthood.
Dr. Berenson presented the findings at an American Medical Association/American Public Health Association media briefing on public health today.
The researchers found offspring of parents with CAD were overweight as children and as they matured, developed additional risk factors such as elevations in total cholesterol, LDL cholesterol, blood sugar and insulin.
"The current observations clearly show the accelerated progression of cardiovascular risk from childhood into adulthood in the offspring of parents with early-onset CAD," the researchers write."Both genetic
predisposition to CAD and environment are important in this regard."
Since CAD runs in families, parental history is recognized as one marker of a child's cardiovascular risk. However, adverse levels of other cardiac risk factors may not become apparent until young adulthood, according to information cited in the study.
Differences between the children of parents with CAD and those whose parents had no history of CAD included:
-- 35 percent of those with a parental history of CAD were obese versus 26 percent obesity rate among those without CAD history.
-- Elevated cholesterol occurred in 8.4 percent of children with parental CAD history versus 4.8 percent in those without.
-- LDL-C levels were elevated in 12.4 percent of those with parental history versus 4.7 percent of the cohort.
-- Hyperglycemia rates were 2.7 percent vs. 0.4 percent in those without a family history of CAD.
-- A higher co-existence of the above conditions was also found in those with a parental history of CAD.
Other studies from Bogalusa have reported that autopsy proven coronary atherosclerotic lesions in deceased children and young adults strongly correlate with risk factors, Dr. Berenson reported in a separate interview.
"During childhood, only being overweight, a modifiable traditional risk factor, was associated significantly with parental CAD," the authors write. "This is of particular interest in terms of prevention and intervention, since being overweight during adolescence has not only been shown to be associated with being overweight as an adult, but it has also been shown to affect future long-term morbidity and mortality."
Many young adults do not have their risk factors measured because there is no evidence of disease. Therefore, it is important to assess children with parental history of CAD for cardiovascular risk.
"Parental history of CAD should not be used as the only criterion for screening young individuals in clinical practice, since many parents of young offspring may still be too young to manifest clinical CAD and they and their children may still be at risk."
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