Absence of risk factor change in young adults after family heart attack or stroke: the CARDIA Study.
BACKGROUND
Health behavior theories suggest that occurrence of heart attack or stroke in an immediate family member should increase one's perceived susceptibility to these conditions, which might lead to improved risk factor behavior and control.


METHODS
Changes in measures of smoking, physical activity, lipids/lipoproteins, body weight, and blood pressure were investigated over two consecutive 5-year follow-up periods among 3950 participants (aged 18 to 30 years) in the Coronary Artery Risk Development in Young Adults (CARDIA) study, who either did or did not have an immediate family member experience a heart attack or stroke. Recruitment and examinations for Years 0, 5, and 10 took place in 1985-1986, 1990-1991, and 1995-1996, respectively.


RESULTS
After adjustment for baseline demographics and risk factors, young adults who experienced a change in family history of heart attack or stroke over a 5-year period were no more likely than those who did not to quit smoking, or to experience more positive changes in weight, physical activity, LDL cholesterol, HDL cholesterol, triglycerides, or systolic or diastolic blood pressure. These findings persisted among the few study participants with one or more established risk factors at baseline.


CONCLUSIONS
The occurrence of a heart attack or stroke in an immediate family member does not appear to lead to self-initiated, sustained change in modifiable risk factors in young adults. Since family history of heart attack and stroke is associated with known risk factors and is an independent risk factor for incident development of these conditions, interventions should be developed and tested to motivate sustained risk-factor control following occurrence of a severe vascular event in a family member.
Kip
Kevin E
KE
Louis de la Parte Florida Mental Health Institute, Department of Mental Health Law and Policy, University of South Florida, Tampa 33612-3807, USA. kkip@fmhi.usf.edu
McCreath
Heather E
HE
Roseman
Jeffrey M
JM
Hulley
Steven B
SB
Schreiner
Pamela J
PJ
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001294:Attitude to Health; D015444:Exercise; D005190:Family; D005260:Female; D015438:Health Behavior; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D016540:Smoking Cessation; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors
D000959:Antihypertensive Agents; D008055:Lipids