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Addition of a novel, protective family history category allows better profiling of cardiovascular risk and atherosclerotic burden in the general population: the Asklepios study

Caroline Van daele, Tim De Meyer UGent, Marc De Buyzere, Thierry Gillebert UGent, Simon Denil, Sofie Bekaert UGent, Julio Chirinos Medina UGent, Patrick Segers UGent, Gui De Backer UGent, Dirk De Bacquer UGent, et al. (2013) PLOS ONE. 8(5).
abstract
Objectives : Whereas the importance of family history (FH) is widely recognized in cardiovascular risk assessment, its full potential could be underutilized, when applied with its current simple guidelines-based definition (cFH): presence of premature cardiovascular disease (CVD) in a first-degree relative. We tested the added value of a new, extended family history definition (eFH), also taking into account later onset of disease, second-degree relatives and number of affected relatives, on profiling cardiovascular risk and atherosclerotic burden in the general population. Design : longitudinal population study. Setting : random, representative population sample from Erpe-Mere and Nieuwerkerken (Belgium, primary care). Subjects : 2524 male/female volunteers, aged 35–55 years, free from overt CVD. Main outcome measures : Subjects were extensively phenotyped including presence of atherosclerosis (ultrasound) and a newly developed FH questionnaire (4 generations). Results : Compared to cFH, eFH was superior in predicting an adverse risk profile (glycemic state, elevated blood pressure, lipid abnormalities, presence of metabolic syndrome components) and presence of atherosclerosis (all age & sex-adjusted p<0.05). Unlike cFH, eFH remained a significant predictor of subclinical atherosclerosis after adjusting for confounders. Most relations with eFH were not graded but showed clear informational breakpoints, with absence of CVD (including late onset) in any first-degree relative being a negative predictor of atherosclerosis, and a particularly interesting phenotype for further study. Conclusions : A novel, extended FH definition is superior to the conventional definition in profiling cardiovascular risk and atherosclerotic burden in the general population. There remain clear opportunities to refine and increase the performance and informational content of this simple, readily-available inexpensive tool.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
prevention, atherosclerosis, cardiovascular risk, risk factors, familial history, metabolic syndrome, CORONARY-HEART-DISEASE, MIDDLE-AGED ADULTS, LOW-DENSITY-LIPOPROTEIN, INTIMA-MEDIA THICKNESS, MYOCARDIAL-INFARCTION, PARENTAL-HISTORY, STROKE, HEALTH, STATEMENT, MEDICINE
journal title
PLOS ONE
PLoS One
volume
8
issue
5
article number
e63185
pages
9 pages
Web of Science type
Article
Web of Science id
000321200500058
JCR category
MULTIDISCIPLINARY SCIENCES
JCR impact factor
3.534 (2013)
JCR rank
8/55 (2013)
JCR quartile
1 (2013)
ISSN
1932-6203
DOI
10.1371/journal.pone.0063185
project
The Asklepios Study
language
English
UGent publication?
yes
classification
A1
additional info
article on behalf of the Asklepios Investigators
copyright statement
I have retained and own the full copyright for this publication
id
3206595
handle
http://hdl.handle.net/1854/LU-3206595
date created
2013-05-03 13:41:11
date last changed
2017-03-07 12:15:31
@article{3206595,
  abstract     = {Objectives : Whereas the importance of family history (FH) is widely recognized in cardiovascular risk assessment, its full potential could be underutilized, when applied with its current simple guidelines-based definition (cFH): presence of premature cardiovascular disease (CVD) in a first-degree relative. We tested the added value of a new, extended family history definition (eFH), also taking into account later onset of disease, second-degree relatives and number of affected relatives, on profiling cardiovascular risk and atherosclerotic burden in the general population.
Design : longitudinal population study.
Setting : random, representative population sample from Erpe-Mere and Nieuwerkerken (Belgium, primary care).
Subjects : 2524 male/female volunteers, aged 35--55 years, free from overt CVD.
Main outcome measures : Subjects were extensively phenotyped including presence of atherosclerosis (ultrasound) and a newly developed FH questionnaire (4 generations).
Results : Compared to cFH, eFH was superior in predicting an adverse risk profile (glycemic state, elevated blood pressure, lipid abnormalities, presence of metabolic syndrome components) and presence of atherosclerosis (all age \& sex-adjusted p{\textlangle}0.05). Unlike cFH, eFH remained a significant predictor of subclinical atherosclerosis after adjusting for confounders. Most relations with eFH were not graded but showed clear informational breakpoints, with absence of CVD (including late onset) in any first-degree relative being a negative predictor of atherosclerosis, and a particularly interesting phenotype for further study.
Conclusions : A novel, extended FH definition is superior to the conventional definition in profiling cardiovascular risk and atherosclerotic burden in the general population. There remain clear opportunities to refine and increase the performance and informational content of this simple, readily-available inexpensive tool.},
  articleno    = {e63185},
  author       = {Van daele, Caroline and De Meyer, Tim and De Buyzere, Marc and Gillebert, Thierry and Denil, Simon and Bekaert, Sofie and Chirinos Medina, Julio and Segers, Patrick and De Backer, Gui and De Bacquer, Dirk and Rietzschel, Ernst},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keyword      = {prevention,atherosclerosis,cardiovascular risk,risk factors,familial history,metabolic syndrome,CORONARY-HEART-DISEASE,MIDDLE-AGED ADULTS,LOW-DENSITY-LIPOPROTEIN,INTIMA-MEDIA THICKNESS,MYOCARDIAL-INFARCTION,PARENTAL-HISTORY,STROKE,HEALTH,STATEMENT,MEDICINE},
  language     = {eng},
  number       = {5},
  pages        = {9},
  title        = {Addition of a novel, protective family history category allows better profiling of cardiovascular risk and atherosclerotic burden in the general population: the Asklepios study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0063185},
  volume       = {8},
  year         = {2013},
}

Chicago
Van daeleCaroline, Tim De Meyer, MARC DE BUYZERE, Thierry Gillebert, Simon Denil, Sofie Bekaert, Julio Chirinos Medina, et al. 2013. “Addition of a Novel, Protective Family History Category Allows Better Profiling of Cardiovascular Risk and Atherosclerotic Burden in the General Population: The Asklepios Study.” Plos One 8 (5).
APA
Van daeleCaroline, De Meyer, T., DE BUYZERE, M., Gillebert, T., Denil, S., Bekaert, S., Chirinos Medina, J., et al. (2013). Addition of a novel, protective family history category allows better profiling of cardiovascular risk and atherosclerotic burden in the general population: the Asklepios study. PLOS ONE, 8(5).
Vancouver
1.
Van daeleCaroline, De Meyer T, DE BUYZERE M, Gillebert T, Denil S, Bekaert S, et al. Addition of a novel, protective family history category allows better profiling of cardiovascular risk and atherosclerotic burden in the general population: the Asklepios study. PLOS ONE. 2013;8(5).
MLA
Van daeleCaroline, Tim De Meyer, MARC DE BUYZERE, et al. “Addition of a Novel, Protective Family History Category Allows Better Profiling of Cardiovascular Risk and Atherosclerotic Burden in the General Population: The Asklepios Study.” PLOS ONE 8.5 (2013): n. pag. Print.