The 130th Annual Meeting of APHA

Abstract #51730

Sharon LR Kardia, PhD¹, Stephen M. Modell, MD, MS², and Patricia A Peyser, PhD¹. (1) Department of Epidemiology, University of Michigan, 109 South Observatory, 3037 School of Public Health I, Ann Arbor, MI 48109-2029, 734-615-8918, skardia@umich.edu, (2) School of Public Health, University of Michigan, M3048, OCBPH, SPH-II, 109 S. Observatory, Ann Arbor, MI 48109-2029

Family history represents the unique genomic, ecologic, and gene-environment interactions that affect the metabolic profile and life course of a family and its members. It is well known that a strong family history of coronary heart disease (CHD) is a significant predictor of an individual’s risk of CHD even after adjusting for an individual's own established risk factors such as hypertension, smoking, and abnormal lipoprotein levels. The explanation for this familial aggregation is not well understood except for the knowledge that genetic and environmental factors predisposing to CHD also aggregate in families. Given the multifactorial nature of CHD risk, it can be argued that an individual’s familial risk of disease may, in fact, be a better indicator of the many complex interactions among genetic and environmental factors that predispose to disease than can be captured by an individual's own risk factors. Issues of how to assess, quantitate, and apply family history information in clinical settings still need to be resolved. Some clinical risk indicators such as the NCEP III guidelines take into account family history while others, such as the Framingham Risk Score, do not. Several family-centered intervention studies have demonstrated the particular advantages of focusing on families rather than just individuals. Although there has been tremendous progress in primary prevention of CHD over the last 20 years, substantial advancements may still be achieved by focusing on the family as its own unit of inference and as a specific target for disease prevention.

Learning Objectives:

• 3. Recognize the significance of family history in predicting risk of coronary heart disease.
  7. Discuss the use of population-based family history screening to identify high risk families for targeted primary prevention.
  11. Describe how family history projects can be used to begin integrating genetics into public health practice.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.