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Pas op als iemand in je gezin
hartproblemen heeft.*
Uit
een studie onder 8.500 gezonde mensen blijkt dat als iemand in een gezin
hartproblemen heeft de kans dat een ander gezinslid ook problemen krijgt
redelijk groot is. Het bewijs hiervoor is zo sterk dat gezinsrelatie toegevoegd
zou moeten worden aan de vier mogelijke risicofactoren te weten; cholesterol,
bloeddruk, leeftijd en roken. (met gezinsrelatie wordt bedoeld de ouder-kind of
kind-kind relatie)
Sibling Heart Attack a Sign You're at Risk, Too
Aggressive steps should be taken to lower that risk,
study finds
MONDAY, Oct. 4
(HealthDayNews) -- If you have a brother or sister who had a heart attack at an early age, start paying attention to your own
arteries because you're at increased risk for heart trouble, a new study finds.
It has long been
accepted that a family history of heart
disease is a sign of potential
problems, said Dr. Roger S. Blumenthal, director of the Johns Hopkins University
Ciccarone Preventive Cardiology Center. But the new study he led helps define
that risk.
The researchers used
an advanced diagnostic technique called electron beam tomography to look for
calcium deposits in more than 8,500 people with no apparent symptoms of heart
disease. These deposits can eventually grow to block an artery.
As expected, the test
found that anyone whose father or mother had had a heart attack was almost twice
as likely to have such deposits as someone whose parents had not had such an
event. But it also found that anyone with a brother or sister who'd had an early
heart attack was three times as likely to have such deposits.
"Our data
strongly support the idea that the use of family history in assessing risk is
important," Blumenthal said.
The study appears in
the Oct. 5 issue of Circulation.
The researchers chose
to look for calcium deposits because they provide an early warning sign of heart
trouble, Blumenthal said. "Other studies will have to look at end points
such as death," he added.
Even before those
studies are done, Blumenthal thinks the evidence is strong enough for family
history to be added to the four major risk factors for heart disease that were
identified by the landmark Framingham Heart Study. Those risk factors are
elevated levels of cholesterol and blood pressure, as well as age and
cigarette smoking.
It was the Framingham
study that identified a doubled cardiac risk for someone with a parent who had
had a major heart problem, Blumenthal said.
"Now they are
analyzing data on whether having a brother or sister with a cardiac event
indicates an increased risk," Blumenthal said. "My suspicion, based on
our data, is that having such a brother or sister will have greater prognostic
power."
He suggests that
anyone with a sibling with heart trouble have a diagnostic test beyond the
standard measures of risk. One test that Blumenthal recommends is for blood
levels of C-reactive protein, a marker of inflammation that has been
linked in many studies to increased heart disease risk.
The American Heart
Association (AHA) does not recommend the electron beam tomography test used in
the Hopkins study because "there is, as yet, no data demonstrating that
actual outcomes are improved in patients who have the test and have an
intervention based on the finding," an AHA statement said.
Whatever extra tests
might be done, Dr. Robert O. Bonow, a professor of medicine at Northwestern
University and a spokesman for the American Heart Association, said, "It is
reasonable to recommend that all treatable risk factors should be identified and
treated very aggressively" when a young brother or sister has a heart
attack.
"What might be a satisfactory level of LDL [bad] cholesterol for an average person might be high for such a person," Bonow said. "The same goes for blood pressure. And those people above all should not be smoking. You can't control your genes, but you can control your smoking habits." (Okt. 2004)