title: Parental Age of Onset of Cardiovascular Disease as a Predictor for Offspring Age of Onset of Cardiovascular Disease.
abstract: OBJECTIVE
  The risk for cardiovascular disease (CVD) is higher for individuals with a first-degree relative who developed premature CVD (with a threshold at age 55 years for a male or 65 years for a female). However, little is known about the effect that each unit increase or decrease of maternal or paternal age of onset of CVD has on offspring age of onset of CVD. We hypothesized that there is an association between maternal and paternal age of onset of CVD and offspring age of onset of CVD.
  
  
  METHODS
  We used the Framingham Heart Study database and performed conditional imputation for CVD-censored parental age (i.e. parents that didn't experience onset of CVD) and Cox proportional regression analysis, with offspring's age of onset of CVD as the dependent variable and parental age of onset of CVD as the primary predictor. Modifiable risk factors in offspring, such as cigarette smoking, body mass index (BMI), diabetes mellitus, systolic blood pressure (SBP), high-density lipoprotein (HDL) level, and low-density lipoprotein (LDL) level, were controlled for. Separate analyses were performed for the association between maternal age of onset of CVD and offspring age of onset of CVD and the association between paternal age of onset of CVD and offspring age of onset of CVD.
  
  
  RESULTS
  Parental age of onset of CVD was predictive of offspring age of onset of CVD for maternal age of onset of CVD (P < .0001; N = 1401) and for paternal age of onset of CVD (P = 0.0134; N = 1221). A negative estimate of the coefficient of interest signifies that late onset of cardiovascular events in parents is protective of onset of CVD in offspring. Cigarette smoking and HDL level were important associated confounders.
  
  
  CONCLUSIONS
  Offspring age of onset of cardiovascular disease is significantly associated with both maternal and paternal age of onset CVD. The incorporation of the parameters, maternal or paternal age of onset of CVD, into risk estimate calculators may improve accuracy of identification of high-risk patients in clinical settings.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.|The University of Texas Health Science Center School of Public Health, Dallas, Texas, United States of America.
authors.forename: Shannon Anjelica
authors.identifier: http://orcid.org/0000-0003-1428-1133
authors.initials: SA
authors.lastname: Allport
authors.affiliation: The University of Texas Health Science Center School of Public Health, Dallas, Texas, United States of America.
authors.forename: Ngum
authors.initials: N
authors.lastname: Kikah
authors.affiliation: The University of Texas Health Science Center School of Public Health, Dallas, Texas, United States of America.|Trinity School of Medicine, Kingstown, St. Vincent and the Grenadines.
authors.forename: Nessim
authors.identifier: http://orcid.org/0000-0001-9235-2211
authors.initials: N
authors.lastname: Abu Saif
authors.affiliation: Texas A &M Health Science Center School of Medicine, Dallas, Texas, United States of America.
authors.forename: Fonkem
authors.initials: F
authors.lastname: Ekokobe
authors.affiliation: The University of Texas Health Science Center School of Public Health, Dallas, Texas, United States of America.
authors.forename: Folefac D
authors.initials: FD
authors.lastname: Atem
mesh_terms: D017668:Age of Onset; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010290:Parents; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL