Cardiovascular diseases: major role of family factors

On the occasion of the European Day of the French Society of Cardiology (Paris), the French Society of Cardiology stressed the importance of genetic and environmental factors in the development of cardiovascular disease, as well as the central role of knowledge family factors, under the theme "Heritage Heart: protect from generation to generation."
This topic was presented at a press conference in Paris in advance of the event.

The role of genetic and is highlighted in conditions of growing. The term genomic medicine begins to appear, showing the ability to determine the risk of developing (or not) a disease from the study of the DNA of a cell of a given individual.

In the area of heart disease, a family history can help predict the risk for an individual to develop a disease of the same type. An example is provided by a Parisian study that involved nearly 7,800 employees in the city of Paris followed for 23 years. After removal of classically associated with risk of myocardial infarction (smoking, hypertension, diabetes, high cholesterol, obesity, parental history of myocardial infarction) factors, the results showed that the risk of sudden death for a given individual is multiplied by 1.8 when one parent has himself been the victim of such an event. In addition, the age of death from sudden death is correlated with that of the parent died suddenly.

It is the same for cardiac arrhythmias, ranging from atrial fibrillation (3.17-fold increased risk in the event of family history, regardless of the existence of any other disease) as well as other cardiac arrhythmias serious as can be observed in the acute phase of infarction (risk multiplied by 2.72.)

For valvular heart disease, certain conditions quite mundane as mitral regurgitation or prolapse in calcified narrowing of the aortic valve may be in a familial form, highlighting a possible genetic involvement.

Very recently, it was found that heart failure could also have a familial transmission, with a risk for offspring multiplied by 2.72 in the case of parental history, completely independent of other risk factors such as those related to myocardial . The so-called Framingham study underlines the contribution of familial factors to the occurrence of heart failure in the general population.

Finally, risk factors for atherosclerosis also have a family origin. Outside of genes and heredity, environmental factors (such as pollution or passive smoking), behavioral factors (such as active smoking or poor eating habits) and lifestyle are often common in a same family and passed down from generation to generation. However, poor eating habits are responsible for premature cardiovascular disease (before age 55 in men and 65 in women), sources of additional serious cardiovascular event risk in the offspring, with overall risk multiplied by 2.

Thus, beyond the classic genetic diseases in which abnormal gene can be passed from generation to generation and provide a family heart disease, other parameters are emerging as powerful cardiovascular risk factors, not only related to hereditary factors still poorly understood, but also to environmental factors and lifestyle habits that are transmitted from generation to generation.

Hence the importance for the medical profession to target these high-risk families to perform the necessary preventive measures in the offspring, both in terms of early diagnosis for a decision more appropriate care, both medical and the lifestyle.