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Heart Failure in Parents a Risk Factor for Children

Study finds 70 percent increased odds for the dangerous condition

WEDNESDAY, July 12, 2006 (HealthDay News) -- When a parent develops heart failure, it could point to a raised risk for the dangerous condition in his or her children, U.S. researchers report.

Data on more than 2,200 participants in the long-running Framingham Heart Study revealed a 70 percent increased incidence of heart failure for persons with a parent with the potentially life-threatening condition, in which the heart cannot pump blood properly.

"We know that some forms of heart failure or cardiomyopathy [inflammation of the heart muscle] clearly have a genetic basis," said Dr. Ramachandran S. Vasan, a professor of medicine at Boston University and an associate investigator with the government-sponsored Massachusetts study. "What our study does is to use family history to assess the risk of common, garden-type heart failure."

Other studies have shown the same relationship, but this is the largest, said Dr. Randall Starling, director of the Cleveland Clinic Heart Failure Center.

The implication for doctors trying to determine an individual's risk of heart failure is that, "When we take a medical history and ask about a family history of high blood pressure and the like, perhaps we should also ask about a family history of heart failure," Vasan said.

That question is already being asked at the Cleveland Clinic and other centers, Starling said.

"It is an important and routine question," he said. "We ask about diabetes, hypertension, have you had a heart attack, and family history is right up on the list of usual things."

The Framingham researchers used imaging techniques to measure indicators of heart failure such as thickening of the heart wall and reduced heartbeat. They found consistently worse conditions among those with a parent who had heart failure.

Over a 10-year follow-up period, heart failure developed in 2.7 percent of those with a parent with heart failure and 1.6 percent of those without such a parent.

The increased risk was present even when the researchers controlled for known risk factors, Vasan said.

The study was not designed to detect the reason for the increased risk, Vasan said. "It could be shared environmental factors or shared genetic factors," he said.

The results are published in the July 13 issue of the New England Journal of Medicine.

Whatever the reason, presence of heart failure in a parent, brother or sister calls for special attention, Starling said. "We recommend they undergo screening," he said. Screening would usually involve ultrasound echocardiogram to determine how well the heart is pumping blood.

Heart failure can be treated with medications such as beta blockers and ACE inhibitors. Persons with heart failure are also told to pay close attention to the classic cardiac risk factors by not smoking, keeping blood pressure and blood-cholesterol levels under control, and keeping physically active under a doctor's guidance.

More information

There's more on heart failure at the American Heart Association.

SOURCES: Ramachandran S. Vasan, professor, medicine, Boston University; Randall Starling, M.D., director, Cleveland Clinic Heart Failure Center, Cleveland; July 13, 2006, New England Journal of Medicine
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