title: Family history of coronary heart disease, health care and health behaviors.
abstract: BACKGROUND
  Previous studies on health care and health behaviors in individuals with a family history of coronary heart disease (CHD) have produced contradictory results, and there is still no evidence that these individuals are more aware of their risk and have improved health behaviors and heath care. This study aims to evaluate health care and health behaviors according to family history of CHD.
  
  
  METHODS
  Individuals randomly selected from the general population living in Porto, Portugal, aged ≥ 18 years (evaluation period: 1999-2003), and without prior history of chronic diseases (n=764), were evaluated by questionnaires on family and personal disease history, health care and health behaviors. A family history of CHD was defined as the occurrence of acute myocardial infarction or sudden death in at least one first-degree relative. Odds ratios and 95% confidence intervals (OR, 95% CI) were calculated using unconditional logistic regression after stratification for age (18-39 vs. ≥ 40 years) and education (≤ 6 vs. >6 years schooling).
  
  
  RESULTS
  Among men, 20% reported a family history of CHD, approximately the same proportion as in women (19.4%) (p=0.900). The proportion of subjects with a family history of CHD was significantly higher in older (≥ 40 vs. 18-39 years: 25.0% vs. 12.0%, p<0.001) and less educated individuals (>6 vs. ≤ 6 years: 27.0% vs. 17.1%, p=0.004). Overall, no significant associations were found between health care and behaviors and CHD family history. Only in younger individuals, after adjustment for education, was a significant positive association found between 1-2 dental visits and CHD family history (OR=2.92; 95% CI: 1.27-6.70). Younger subjects who smoked and consumed alcohol and caffeine also presented a higher probability of having CHD family history, but the associations were not statistically significant.
  
  
  CONCLUSIONS
  In this population without disease requiring regular medical care, individuals with CHD family history had similar care-seeking patterns and health behaviors to those without. These results suggest a lack of awareness of their increased risk and highlight the importance of developing measures to promote sustained and effective changes in risk factors in individuals with genetic susceptibility to CHD.
authors.affiliation: Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Tavares
authors.forename: Andreia
authors.initials: A
authors.lastname: Oliveira
authors.forename: Carla
authors.initials: C
authors.lastname: Lopes
mesh_terms: D000293:Adolescent; D000328:Adult; D003327:Coronary Disease / Q000235:genetics* / Q000628:therapy*; D003695:Delivery of Health Care; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D055815:Young Adult