Screen relatives for heart disease

SCREENING relatives of patients with premature heart disease may prevent as many as a third of heart attacks in men younger than 55, a study has found.Scottish researchers reviewed 21 studies and found first-degree relatives of patients with coronary heart disease before the age of 55 for men and 60 for women had a much greater risk of having a myocardial infarction themselves, due to genetic disposition and shared lifestyle factors.

Siblings were found to have at least double the risk compared to the general population. "More than a third of admissions for premature myocardial infarction could be prevented by screening and treating first-degree relatives," the authors said.

They said siblings, children and even partners of patients with early heart disease would benefit from screening and subsequent modification of risk factors such as smoking and high blood pressure.

They highlighted a US study that revealed 14% of families with a positive family history accounted for 48% of all coronary heart disease events and 72% of all early heart disease events.

Their data also showed that of 5553 patients admitted to hospital with heart disease, only 20% had family members screened within the following six months (BMJ 2007;335:481-85).

The authors estimated the potential impact of using hospital admissions for premature heart attacks as a screening tool to identify high-risk relatives.

If such screening led to targeted interventions, the researchers estimated that for every 14 patients found to have early heart disease, one cardiovascular event could be prevented in siblings within five years.

"First-degree relatives are a... neglected group at which primary prevention should be targeted," they concluded.