How accurately do adult sons and daughters report and perceive parental deaths from coronary disease?

Objectives-To describe how adult sons and daughters report and perceive par ental deaths from heart disease Design-Two generation family study. Setting-West of Scotland. Subjects-1040 sons and 1298 daughters aged 30-59 from 1477 families, whose fathers and mothers were aged 45-64 in 1972-76 and have been followed up fo r mortality over 20 years. Outcome-Perception of a "family weakness" attributable to heart disease. Results-26% of sons and daughters had a parent who had died of coronary hea rt disease (CHD). The proportion was higher in older offspring (+18% per 10 year age difference) and in manual compared with non-manual groups (+37%). Eighty nine per cent of parental deaths from CHD were correctly reported b y offspring. Only 23% of sons and 34% of daughters with at least one parent who had died of CHD considered that they had a family weakness attributabl e to heart disease. Perceptions of a family weakness were higher when one o r both parents had died of CHD, when parental deaths occurred at a younger age, in daughters compared with sons and in offspring in non-manual compare d with manual occupations. Conclusions-Only a minority of sons and daughters with experience of a pare nt having died from CHD perceive this in terms of a family weakness attribu table to heart disease. Although men in manual occupations are most Likely to develop CHD, they are least likely to interpret a parental death from CH D in terms of a family weakness. Health professionals giving advice to pati ents on their familial risks need to be aware of the difference between cli nical definitions and lay perceptions of a family history of heart disease.