title: Association of parental heart failure with risk of heart failure in offspring.
abstract: BACKGROUND
  The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting.
  
  
  METHODS
  We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study (mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring (mean age, 44 years; 1150 women).
  
  
  RESULTS
  As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass (17.0 percent vs. 26.9 percent), left ventricular internal dimensions (18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction (3.1 percent vs. 5.7 percent); the multivariable-adjusted odds ratios were 1.35 (95 percent confidence interval, 0.99 to 1.84), 1.29 (95 percent confidence interval, 0.96 to 1.72), and 2.37 (95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up (mean length of follow-up, 20 years). The age- and sex-adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment (hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60).
  
  
  CONCLUSIONS
  Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart-failure burden in the community.
authors.affiliation: Framingham Heart Study of the National Heart, Lung, and Blood Institute, Framingham, Mass, USA.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Lee
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D032721:Adult Children; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018618:Echocardiography, Doppler, Color; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010290:Parents; D015995:Prevalence; D016016:Proportional Hazards Models; D012306:Risk; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology*