Article

Influence of Family History of Cardiovascular Disease on Clinicians’ Preventive Recommendations and Subsequent Adherence of Patients without Cardiovascular Disease

Oregon Genetics Program, Public Health Division, Oregon Department of Human Services, Portland, OR 97232, USA.
Public Health Genomics (Impact Factor: 2.21). 03/2010; 13(7-8):457-66. DOI: 10.1159/000293991
Source: PubMed

ABSTRACT

Family history of cardiovascular disease (CVD) is an independent risk factor for CVD. Therefore, efforts to prevent CVD among asymptomatic persons with a family history are warranted. Little is known about preventive recommendations clinicians offer their patients with a family history of CVD, and adherence to preventive recommendations by patients at risk for CVD has not been well described.
We used the 2007 Oregon Behavioral Risk Factor Surveillance System to evaluate among 2,566 adults without CVD associations between family history of CVD and (a) clinician recommendations; (b) perceived risk of developing CVD; (c) adoption of preventive and screening behaviors; and (d) risk factors of CVD.
Compared with adults with no family history of CVD, those with a family history reported that their clinician was more likely to ask about their family history information (OR = 2.6; 95% CI, 1.9-3.4), discuss the risk of developing CVD (OR = 2.0; 95% CI, 1.6-2.5), and make recommendations to prevent CVD (OR = 2.1; 95% CI, 1.7-2.7). Family history and clinician recommendations were associated with a higher likelihood of reported changes in diet or physical activity to prevent CVD (OR = 2.7; 95% CI, 2.3-3.2). Persons with a family history of CVD were more likely to report having high cholesterol, having high blood pressure, taking aspirin, and having had their cholesterol checked.
The presence of a family history of CVD appears to prompt clinicians to recommend preventive changes and may motivate patients without CVD to adopt these recommendations.

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    • "Females (60.87%) were more frequently recorded with positive family history than males (54.66%). Similarly, Van der Sande et al. (2001) and Zlot et al. (2010) found a higher reporting of family history by females in their study population. A positive association between family history and high education level (42.61%; "
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    ABSTRACT: Objective: Family history, one of the traditional tools in clinical medicine, is frequently neglected which can be used to identify persons at increased cardiovascular disease (CVD) risk. The present study aimed to determine the influence of family history on cardiovascular health. Methodology: A cross sectional study was conducted on the retired defense personnel to study the relation of socio-demographic varia-bles, physical activity, body mass index, sleep, stress and metabolic syndrome with family history from Jun to Oct, 2013. Chi Square test was used with statistical significance of P value <0.05. Results: A positive family history was reported among 32.77% of the study subjects with statistically significant higher recording by females (60.87%; P <0.01), those who were aged 20-60years (62.60%; P<0.001), and had higher education level (42.61%; P<0.05). A statistically significant stress (29.56%; P<0.001), sedentary lifestyle (72.17%; P<0.05) and insomnia (29.56%) was reported among sub-jects reporting positive family history. A statistically significant prevalence of metabolic syndrome (36.53%; P<0.05), hypertension (56.52%; P<0.01), obesity (54.78%), dyslipidemia (33.05%; P<0.05) and dysglycemia (31.31%; P<0.05) was more in subjects reporting positive than negative family history (metabolic syndrome: 23.73%; (P<0.05); hypertension: 41.52% (P<0.01); obesity: 50.00%; dyslipidemia: 21.61% (P<0.05); dysglycemia: 21.19% (P<0.05)). Conclusions: A statistical association between positive family history and metabolic syndrome shows CVD susceptibility which prompts to utilize every opportunity to involve concerned families in health education by promoting healthy lifestyle changes in their diet and physical activity. Keywords: Cardiovascular Disease, Family History, Metabolic Syndrome.
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    ABSTRACT: Family history is an independent risk factor for many chronic conditions. Therefore, efforts to prevent these diseases among asymptomatic people at high familial risk are justified to reduce the health burden of these chronic conditions. We analyzed 2006-2009 Oregon Behavioral Risk Factor Surveillance System data to examine associations between family history of diabetes, cardiovascular disease (CVD), colorectal cancer (CRC), breast cancer (BC), and: (1) patient-reported clinician recommendations, (2) adoption of preventive and screening behaviors, and (3) chronic disease risk factors among respondents without a personal history of the condition. A positive family history was associated with a higher likelihood of reported discussion by clinicians of CRC and BC screening and a greater likelihood of respondents having cholesterol and CRC screening. The combination of family history and clinician recommendations significantly increased the odds of CRC and BC screening compared to family history alone. A positive family history was also associated with respondents reporting lifestyle changes to prevent diabetes, CVD, and CRC, but not BC. Awareness of family history prompts clinicians to recommend screening and may motivate patients to be screened. Understanding positive family history may also motivate patients to adopt healthy lifestyles.
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    ABSTRACT: BACKGROUND:: More than 82 million Americans have 1 or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD, and health-related behavior is poorly understood. OBJECTIVE:: The objective of this article was to review and summarize the published research on the relationship between an FH of CVD, an individual's perceived risk, and health-related behavior to make recommendations for clinical practice and future research. METHODS:: A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between an FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. A total of 238 were excluded, resulting in a total of 25 articles included in the review. RESULTS:: There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between an FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent. CONCLUSIONS:: A person's awareness of his or her FH of CVD or his or her own risk for CVD is not a sufficient predictor of changes in his or her health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with an FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk.
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