Familial history of stroke and stroke risk. The Family Heart Study.
OBJECTIVE
Although familial history of stroke is generally perceived to be an important marker of stroke risk, very few epidemiological studies have been published to address this hypothesis. We sought to examine whether familial history of stroke is associated with the prevalence of stroke in the Family Heart Study, a National Heart, Lung, and Blood Institute-supported multicenter study of the familial, genetic, and nongenetic determinants of cardiovascular disease in populations.


METHODS
The personal and familial histories of stroke were assessed in 3168 individuals (probands) who were at least 45 years old and 29,325 of their first-degree relatives with the use of a standardized questionnaire.


RESULTS
The age-, ethnicity-, and sex-adjusted stroke prevalences were 4.8%, 4.9%, and 3.9% in probands with a positive familial, paternal, and maternal history of stroke, respectively, in comparison with 2.0% in probands without any positive familial history (P < .01). The age-, ethnicity-, and sex-adjusted odds ratios (95% confidence interval) of stroke were 2.00 (1.13, 3.54) for a positive paternal and 1.41 (0.80, 2.50) for a positive maternal history of stroke. Additional statistical adjustment for the proband's history of elevated cholesterol level, cigarette smoking status, history of coronary heart disease, hypertension, and diabetes did not alter the associations. A similar pattern was seen for African Americans and European Americans.


CONCLUSIONS
The increased risk of stroke among persons with a positive familial history of stroke compared with those without a familial history of stroke is consistent with the expression of genetic susceptibility, a shared environment, or both in the etiology of stroke.
Liao
D
D
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill 27514, USA. duanping_liao@unc.edu
Myers
R
R
Hunt
S
S
Shahar
E
E
Paton
C
C
Burke
G
G
Province
M
M
Heiss
G
G
D001741:Black or African American; D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D005220:Fathers; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008429:Maternal Welfare; D008499:Medical Records; D008875:Middle Aged; D009035:Mothers; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People