Expanding the definition of a positive family history for early-onset coronary heart disease

Purpose: Assessing familial risk for early-onset coronary heart disease (CHID) is typically limited to first-degree relatives with early-onset CHID. To evaluate the impact of additional family history, we examined the associations between various family history definitions and early-onset CHID. Methods: By using the national HealthStyles 2003 survey data, we assessed associations between self-reported family history and personal history of early-onset CHID (diagnosed at or before age 60 years), adjusting for demographics, hypercholesterolemia, hypertension, and obesity. Results: Of 4035 respondents, 60% were female and 72% were white, with a mean age of 48.8 years; 4.4% had early-onset CHID. In addition to having at least one first-degree relative with early-onset CHID, other significant associations included having at least one first-degree relative with late-onset CHID, at least one second-degree relative with early-onset CHID, and two or more affected second-degree relatives regardless of age of onset of CHO. Early-onset stroke in at least one first-degree relative and, in women, having at least one first-degree relative with diabetes were also significantly associated with early-onset CHO. Conclusions: Family history beyond early-onset CHID in first-degree relatives is significantly associated with prevalent CHID diagnosed at or before age 60 years.