Parental death from heart disease and the risk of heart attack

In the British Regional Heart Study, 7735 men aged 40–59 years were asked at initial screening whether their father or mother was alive or dead and to what cause any death had been attributed. They were followed up for the occurrence of major ischaemic heart disease events. At screening the men reported that 23% of the fathers and 43% of the mothers were alive and that 19% of the fathers and 11% of the mothers had died of heart trouble. In a sample of parental deaths, the death certificate was obtained and it was found that a son's report of a parental death from ’heart trouble‘ was a reliable indication that death had been certified to ischaemic heart disease. However, about half of the parental deaths certified as ischaemic heart disease were not reported as ‘heart trouble’ by their sons. A major ischaemic heart disease event was experienced by 336 men over an average follow-up of 6.2 years. Men who said their father had died from ‘heart trouble’ were at twice the risk of a major ischaemic heart disease event compared with men whose fathers were still alive and 1.5 times the risk of men who reported their father to be dead from another or unknown cause, even after accounting for age, systolic blood pressure, serum total cholesterol, cigarette smoking and serum HDL-cholesterol. For men with mother dead from heart trouble, the corresponding figures were 1.3 and 10. The results are consistent with those from other prospective studies in indicating that men with a parental history of ischaemic heart disease are at increased risk of a heart attack and that only a small proportion of this excess risk is explained by increased levels of the risk factors at screening. There appears to be a familial risk factor, environmental or genetic, expressed by parental death from heart disease, which merits further investigation by detailed family studies of ischaemic heart disease.