Influence of Family History of Cardiovascular Disease on Clinicians’ Preventive Recommendations and Subsequent Adherence of Patients without Cardiovascular DiseaseZlot A.I. · Valdez R. · Han Y. · Silvey K. · Leman R.F.
aOregon Genetics Program, bHealth Promotion and Chronic Disease Prevention Program and cOffice of Disease Prevention and Epidemiology, Public Health Division, Oregon Department of Human Services, Portland, Oreg., and dOffice of Public Health Genomics, Centers of Disease Control and Prevention, Atlanta, Ga., USA
Background: Family history of cardiovascular disease (CVD) is an independent risk factor for CVD. Therefore, efforts to prevent CVD among asymptomatic persons with a family history are warranted. Little is known about preventive recommendations clinicians offer their patients with a family history of CVD, and adherence to preventive recommendations by patients at risk for CVD has not been well described. Methods: We used the 2007 Oregon Behavioral Risk Factor Surveillance System to evaluate among 2,566 adults without CVD associations between family history of CVD and (a) clinician recommendations; (b) perceived risk of developing CVD; (c) adoption of preventive and screening behaviors; and (d) risk factors of CVD. Results: Compared with adults with no family history of CVD, those with a family history reported that their clinician was more likely to ask about their family history information (OR = 2.6; 95% CI, 1.9–3.4), discuss the risk of developing CVD (OR = 2.0; 95% CI, 1.6–2.5), and make recommendations to prevent CVD (OR = 2.1; 95% CI, 1.7–2.7). Family history and clinician recommendations were associated with a higher likelihood of reported changes in diet or physical activity to prevent CVD (OR = 2.7; 95% CI, 2.3–3.2). Persons with a family history of CVD were more likely to report having high cholesterol, having high blood pressure, taking aspirin, and having had their cholesterol checked. Conclusion: The presence of a family history of CVD appears to prompt clinicians to recommend preventive changes and may motivate patients without CVD to adopt these recommendations.
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