A positive family history of cardiometabolic diseases increased the odds of worsening LV hypertrophy and high LV filling pressure by 20% over 7 years in healthy youth.
Does a family history of cardiometabolic diseases increase the risk of worsening structural and functional cardiac damage in healthy youths?
A family history of cardiometabolic diseases in healthy youths is associated with a 20% increased odds of premature worsening cardiac structural and functional damage over 7 years, independent of traditional risk factors.
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Abstract Background The genetic basis of atherosclerosis and metabolic diseases has been established in adults. However, the earliest manifestation of cardiac alterations secondary to a family history of cardiometabolic disease remains uncharacterized, especially in a large cohort of apparently healthy adolescents. This is partly due to the scarcity of repeated echocardiography measures. Such evidence will be clinically relevant towards the primordial and primary prevention of premature cardiovascular events. Purpose To examine the prevalence of the family history of cardiometabolic diseases among healthy youths and the longitudinal effects on the risk of worsening structural and functional cardiac damage. Methods From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 1595 adolescents aged 17 years were included. Family history of hypertension, diabetes, high cholesterol, and vascular disease (cardiometabolic diseases) was collected by questionnaire when participants were 17 years of age. Repeated echocardiography measured left ventricular mass indexed for height2.7 (LVMI2.7), relative wall thickness (RWT), LV diastolic function from mitral E/A ratio (LVDF), and LV filling pressure from E/e´ ratio (LVFP) were available at ages 17 years and age 24 years follow-up. LVMI2.7 ≥51g/m2.7, RWT ≥0.44, LVDF1.5, and LVFP ≥8 were categorized as LV hypertrophy, high RWT, LVD dysfunction, and high LVFP, respectively. Multivariable adjusted associations were examined using generalized linear mixed-effect models with logit-link and adjusted for sex, socioeconomic status, and time-varying covariates measured at both baseline and follow-up such as age, heart rate, systolic blood pressure, fat mass, lean mass, smoking status, sedentary time, light physical activity, moderate-to-vigorous physical activity, and fasting low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol glucose, insulin, and glycoprotein acetyl. Results Among 1595 adolescents, (mean SD age at baseline, 17.74 0.38 years; 955 59.8% females]), 30.2% had a positive family history of cardiometabolic diseases. The prevalence of LV hypertrophy increased from 2.6% to 7.9%, over 7 years. In a fully adjusted model, positive family history of cardiometabolic diseases was significantly associated with higher odds of progressively worsening LV hypertrophy (odds ratio 1.20 95% CI, 1.09 – 1.32, p0.001) and high LVFP (1.20 1.09 – 1.31, p0.001), but not high RWT and LVD dysfunction, across the 7-year cardiac observation period. Conclusion One-third of apparently healthy youth have a positive family history of cardiometabolic diseases, increasing the odds of premature worsening cardiac damage by 20%, independent of traditional cardiovascular risk factors. Familial cardiometabolic risk may accelerate pathologic cardiac remodeling from adolescence. Targeted interventions to prevent future cardiac events in these at-risk youths are warranted.
Corsi et al. (Sat,) reported a other. A positive family history of cardiometabolic diseases increased the odds of worsening LV hypertrophy and high LV filling pressure by 20% over 7 years in healthy youth.