Does your brother or sister have heart disease? That may be a better predictor of whether you are at risk that your parents' health history, researchers said.

A study of nearly 8,500 healthy adults in Ohio found that people were 2.5 times to three times more likely to have coronary atherosclerosis -- heart and artery disease -- if a brother or sister had already been diagnosed with heart disease.

There was a correlation with parents, too, but much less so, according to the report in this week's issue of the journal Circulation.

Doctors should take a careful family history from patients that includes brothers and sisters, the researchers at Johns Hopkins University in Baltimore, Ohio State University and the University of California Los Angeles said.

Patients are usually asked if their mother or father had a range of diseases or conditions, but often the health history of brothers and sisters is overlooked.

"Family history has for years been recognized as a risk factor in predicting a person's chance for developing coronary heart disease early on in life -- separate from better-known risk factors, such as HDL ('bad') and LDL ('good') cholesterol levels, blood pressure, smoking and age," said cardiologist Dr. Roger Blumenthal, who led the study.

"But we never knew if there was a difference between sibling and parental histories of early heart disease in terms of a given individual's risk of developing early atherosclerosis."

The Johns Hopkins team used electron-beam tomography, a form of computed tomography or CAT scans to look for buildups of calcium in the coronary artery, a main artery leading to the heart. This is an early signal of heart disease.

People whose brother or sister had suffered a heart attack or who needed bypass surgery or angioplasty were nearly four times more likely to have advanced levels of atherosclerosis than those with no family history of heart disease.

People whose parents had heart disease, but not siblings, were about twice as likely to have advanced levels of coronary calcium.

Even people who seem healthy may need to work hard to lower their risk of heart disease if their brothers or sisters have it, Blumenthal said. That may include early use of drugs such as aspirin or a statin as well as good diet and exercise.

Reference Source 89
October 5, 2004

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