Are there sex differences in risk factors for coronary heart disease? Maternal versus paternal transmission

摘要

Parents are held accountable for many things in their children's lives―both good and bad. The relative importance of the mother's role versus the father's role is often debated, and the relative importance of parental transmission to heart disease risk is no exception. As with many traits, there is clearly a role of nature and nurture in the occurrence of heart disease. The role of the intrauterinc environment in determining coronary heart disease (CHD) risk is not nearly as well defined as the role of traditional cardiac risk factors. It is estimated from large studies such as MRFIT, the Nurses Health Study, and Chicago Western Electric study that the major independent conventional risk factors can account for more than 80% of coronary heart disease. Premature family history (mother < 65 years, father < 55 years) of CHD is a risk factor for CHD. While-family history is clearly not modifiable, its importance is in determining overall risk. Current American Heart Association and European Society of Cardiology guidelines support tailoring the aggressiveness of risk factor reduction to the number of risk factors present. When premature family history is present, then other modifiable risk factors such as hypertension, obesity, or hypercholesterolacmia should be treated more aggressively.