JACC Asia. 2025 Dec 30:S2772-3747(25)00690-8. doi: 10.1016/j.jacasi.2025.10.031. Online ahead of print.
ABSTRACT
BACKGROUND: Evidence on the association between family history and atherosclerotic cardiovascular disease (ASCVD) across age groups remains limited.
OBJECTIVES: This study aimed to evaluate the relations of family history of ASCVD (FHA) with incident ASCVD and its predictive value across age groups in China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) and UK Biobank.
METHODS: A total of 117,640 Chinese and 457,781 UK adults were included from 2 population-based cohorts, with family history assured by face-to-face interviews with standardized questionnaires.
RESULTS: During median follow-ups of 6.0 (Q1-Q3: 5.7-11.4) years (China-PAR) and 11.8 (Q1-Q3: 11.0-12.5) years (UK Biobank), 4,681 and 26,913 ASCVD cases occurred. Generally, FHA was consistently associated with higher ASCVD risk, but the association weakened with age (Pinteraction < 0.001). The strongest effect was in adults <45 years, with HRs of 1.48 (95% CI: 1.11-1.96) in China-PAR and 1.47 (95% CI: 1.23-1.76) in UK Biobank, which was transformed to 6.75 and 5.33 years ASCVD-free years lost at the index of 20 years, and this gap decreased to 3.40 and 1.42 years at the index of 80 years, respectively. Notably, sibling history conferred greater risk than parental history (Pheterogeneity < 0.001).
CONCLUSIONS: In both populations, FHA is a key indicator for identifying high ASCVD risk, especially in younger individuals, with a stronger impact driven by sibling history. These findings highlight the importance of tailoring recommendations for identifying high-risk individuals based on family history, with consideration of different age groups.
PMID:41712897 | DOI:10.1016/j.jacasi.2025.10.031
