Abstract
OBJECTIVES—To describe how adult sons and daughters report and perceive parental 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 for 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 heart 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 by 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 attributable to heart disease. Perceptions of a family weakness were higher when one or 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 compared with manual occupations. CONCLUSIONS—Only a minority of sons and daughters with experience of a parent having died from CHD perceive this in terms of a family weakness attributable to heart disease. Although men in manual occupations are most likely to develop CHD, they are least likely to interpret a parental death from CHD in terms of a family weakness. Health professionals giving advice to patients on their familial risks need to be aware of the difference between clinical definitions and lay perceptions of a family history of heart disease. Keywords: coronary heart disease; family history; social class
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Selected References
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- Barrett-Connor E., Khaw K. Family history of heart attack as an independent predictor of death due to cardiovascular disease. Circulation. 1984 Jun;69(6):1065–1069. doi: 10.1161/01.cir.69.6.1065. [DOI] [PubMed] [Google Scholar]
- Bell J. The new genetics in clinical practice. BMJ. 1998 Feb 21;316(7131):618–620. doi: 10.1136/bmj.316.7131.618. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Colditz G. A., Stampfer M. J., Willett W. C., Rosner B., Speizer F. E., Hennekens C. H. A prospective study of parental history of myocardial infarction and coronary heart disease in women. Am J Epidemiol. 1986 Jan;123(1):48–58. doi: 10.1093/oxfordjournals.aje.a114223. [DOI] [PubMed] [Google Scholar]
- Emery J., Rose P. Expanding the role of the family history in primary care. Br J Gen Pract. 1999 Apr;49(441):260–261. [PMC free article] [PubMed] [Google Scholar]
- Frankel S., Davison C., Smith G. D. Lay epidemiology and the rationality of responses to health education. Br J Gen Pract. 1991 Oct;41(351):428–430. [PMC free article] [PubMed] [Google Scholar]
- Hawthorne V. M., Watt G. C., Hart C. L., Hole D. J., Smith G. D., Gillis C. R. Cardiorespiratory disease in men and women in urban Scotland: baseline characteristics of the Renfrew/Paisley (midspan) study population. Scott Med J. 1995 Aug;40(4):102–107. doi: 10.1177/003693309504000402. [DOI] [PubMed] [Google Scholar]
- Hunt K., Davison C., Emslie C., Ford G. Are perceptions of a family history of heart disease related to health-related attitudes and behaviour? Health Educ Res. 2000 Apr;15(2):131–143. doi: 10.1093/her/15.2.131. [DOI] [PubMed] [Google Scholar]
- Hunt S. C., Williams R. R., Barlow G. K. A comparison of positive family history definitions for defining risk of future disease. J Chronic Dis. 1986;39(10):809–821. doi: 10.1016/0021-9681(86)90083-4. [DOI] [PubMed] [Google Scholar]
- Schildkraut J. M., Myers R. H., Cupples L. A., Kiely D. K., Kannel W. B. Coronary risk associated with age and sex of parental heart disease in the Framingham Study. Am J Cardiol. 1989 Sep 15;64(10):555–559. doi: 10.1016/0002-9149(89)90477-3. [DOI] [PubMed] [Google Scholar]
- Silberberg J. S., Wlodarczyk J., Fryer J., Ray C. D., Hensley M. J. Correction for biases in a population-based study of family history and coronary heart disease. The Newcastle Family History Study I. Am J Epidemiol. 1998 Jun 15;147(12):1123–1132. doi: 10.1093/oxfordjournals.aje.a009410. [DOI] [PubMed] [Google Scholar]
- Summerton N., Garrood P. V. The family history in family practice: a questionnaire study. Fam Pract. 1997 Aug;14(4):285–288. doi: 10.1093/fampra/14.4.285. [DOI] [PubMed] [Google Scholar]