Associations between a parental history of premature cardiovascular disease and coronary artery calcium and carotid intima-media thickness: the Coronary Artery Risk Development In Young Adults (CARDIA) study

BACKGROUND: It is unclear if associations between a parental history of premature CVD (pCVD) and subclinical atherosclerosis are attenuated by adjustment for long-term risk factor levels through middle adulthood. DESIGN: Prospective community-based cohort study. METHODS: CARDIA participants who attended the year-20 exam (n = 2283, mean age 45 years) were grouped by pCVD status: maternal only, paternal only, any parental, and no parental history (referent). We used separate logistic regression models, adjusted for average risk factor levels over a 20-year follow up to assess associations of parental pCVD and subclinical atherosclerosis in offspring. RESULTS: White participants with any parental history of pCVD had a higher odds of coronary artery calcium (CAC) >0 than participants with no parental history (OR 1.55, 95% CI 1.01-2.37). This was largely driven by the association of a paternal history of pCVD with CAC >0 (OR 2.15, 95% CI 1.42-3.23), which was minimally attenuated by multivariable adjustment (OR 2.09, 95% CI 1.31-3.32). Similarly, adjusted associations between parental pCVD and intima-media thickness (IMT) >90% were observed in white participants with a paternal history of pCVD (OR 1.93, 95% CI 1.10-3.39) and any parental history pCVD (OR 1.67, 95% CI 1.02-2.74). No significant associations between a parental history of pCVD and the odds of subclinical atherosclerosis were observed in black participants. CONCLUSIONS: Parental pCVD is independently associated with early development of subclinical atherosclerosis; these associations may be race-specific for participants in their fifth decade of life.