title: Parental history and the risk of subsequent vascular events in patients with clinically manifest vascular disease: the effects of sex of the parent and vascular disease location.
abstract: BACKGROUND
  Parental history of cardiovascular disease is a risk factor for first vascular events. It is unknown whether this also holds for subsequent events in patients with vascular disease. Also, the role of the location of parental vascular disease and the sex of the affected parent is unidentified.
  
  
  METHODS
  In a cohort of 4529 patients with symptomatic vascular disease enrolled in the Second Manifestations of Arterial Disease (SMART) Study, the relation between parental cardiovascular history under the age of sixty, sex of the parent, location of parental vascular disease (heart, brain, lower extremities) and subsequent myocardial infarction (MI), stroke, vascular death and peripheral artery disease (PAD) was determined by Cox-proportional hazard analyses.
  
  
  RESULTS
  During a median follow-up of 4.9 years (interquartile range 2.5-7.0), MI was experienced by 220 patients, stroke by 112, PAD by 297, whereas 371 patients died. A positive parental history of cardiovascular disease, without knowledge of vascular disease location and sex of that particular parent, was not associated with subsequent events (HR1.0; 95%CI 0.8-1.3). For specific types of parental history regarding sex and vascular location, having a father with a history of PAD was related to an increased risk of incident PAD (HR3.1; 95%CI 2.1-4.6).
  
  
  CONCLUSIONS
  A positive parental history of cardiovascular disease without information about vascular disease location and sex does not increase the risk of recurrent vascular events in patients with symptomatic vascular disease. Vascular patients with a father with PAD have an increased risk of subsequent peripheral artery disease compared with vascular patients without such a family history.
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Weijmans
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: de Borst
authors.affiliation: Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, The Netherlands.
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: Nathoe
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, The Netherlands. Electronic address: f.l.j.visseren@umcutrecht.nl.
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
keywords: Cardiovascular disease; Parental history; Parental sex; Parental vascular disease location; Recurrent vascular events