Parental history of premature coronary heart disease mortality and signs of ischemia on the resting electrocardiogram

OBJECTIVES Here we explore the association between a family history of premature coron ary heart disease (CHD) death and ischemic electrocardiogram (ECG) findings in the offspring. BACKGROUND In the general population, signs of ischemia are found on the resting ECG i n about 10% of middle-aged men and women. Their independent predictive valu e for CI-ID morbidity and mortality has been shown in several studies. METHODS Our results are based on cross-sectional data from three large epidemiologi cal studies performed in Belgium during the past two decades: the Belgian H eart Disease Prevention Project (n = 8,145), the Belgian Interuniversity Re search on Nutrition and Health survey (n = 7,625) and the MONICA project (n = 3,193). A parental history of fatal CHD was if the father died from CHD before age 60 or the mother before age 70. Ischemic ECG findings were defin ed according to Minnesota Code criteria I1-3, IV1-3, considered premature V 1-3 or VII1. RESULTS Subjects with a parental history of premature CHD death were found to have experienced significantly more frequently symptomatic CHD. After exclusion of symptomatic individuals, no major differences in lifestyle-related risk factors were found between the groups with and without a parental history o f premature fatal CHD. After multivariate adjustment for age, smoking, body mass index and sex, the odds ratios land 95% confidence interval [CII) for ECG ischemia associated with a positive parental history of premature deat h were 1.42 (1.10-1.82), 1.47 (1.16-1.88) and 1.37 (0.78-2.41) in the three studies. Additional adjustment for systolic blood pressure, total choleste rol and, if available, lifestyle-related factors did not alter the magnitud e of the odds ratios. Overall, in men aged 45 to 64 years, ECG ischemia was significantly more frequent (36% excess) in those with positive parental h istory. CONCLUSIONS Subjects in whom one or both parents died prematurely from cardiac related diseases have signs of ischemia more frequently on their electrocardiogram, and this is independent of other risk factors. (C) 1999 by the American Co llege of Cardiology.