Influence of parental histories of cardiovascular risk factors on risk factor clusters in the offspring.

OBJECTIVES: To assess the effect of parental histories of cardiovascular risk factors on risk factor clusters (RFC) in representative samples from three French populations (MONICA centers of Lille, Strasbourg, Toulouse). MATERIAL AND METHODS: In a representative cross-sectional study, we screened 1,291 males and 1,264 females, aged 35-64 years. Subjects were defined as RFC cases when they were affected by at least 2 disorders among, hypertension (systolic or diastolic blood pressure >=140/90 mmHg and/or antihypertensive drug), diabetes (physician-diagnosed diabetes and/or glycemia >=7.0 mmol/l and/or hypoglycemic drug), and dyslipidemia (triglycerides > 2.26 mmol/l and/or HDL-cholesterol<0.9 mmol/l in men and<1.2 mmol/l in women). Nineteen percent of the subjects were RFC cases. Parental histories of cardiovascular risk factors (hypertension, diabetes, hyperlipidemia) were positive if they were under 65. About 29% of the subjects had at least one parental history of risk factor. RESULTS: After adjustment for sex, age, educational level, sedentary lifestyle, alcohol consumption, body mass index, LDL cholesterol and center, parental histories of cardiovascular risk factors were significantly associated with the RFC. One, two, or at least three parental histories were significantly associated with increased odds of being RFC cases (adjusted OR 1.39 95% CI [1.05-1.82], 2.90 95% CI [1.91-4.40], 2.93 95% CI [1.41-6.08]). Furthermore, a maternal-only history vs a paternal-only history of hypertension or diabetes was associated with strong odds of being an RFC case. CONCLUSION: At least a single cardiovascular risk factor in parents was significantly associated with RFC in offspring, independently of environmental parameters.

Proposed classification criteria of psoriatic arthritis. A preliminary study in 260 patients.

UNLABELLED: Psoriatic arthritis probably owes to its radioclinical presentation its position as the most controversial and poorly understood of all major chronic inflammatory joint diseases. Differentiating psoriatic arthritis from ankylosing spondylitis and rheumatoid arthritis remains difficult. OBJECTIVE: To conduct a statistical analysis aimed at identifying clinical, radiological, and laboratory criteria for classifying psoriatic arthritis. PATIENTS AND METHODS: 260 patients were studied retrospectively, including 100 cases with psoriatic arthritis and 160 controls with ankylosing spondylitis meeting Amor's criteria (n = 80) or with rheumatoid arthritis meeting American College of Rheumatology criteria (n = 80). Mean disease duration was five years. Thirty-nine variables were recorded for each patient. Multiple logistic regression and discriminant analysis were used to select the classification criteria. RESULTS: Each of the two statistical methods selected the same nine criteria. After assigning a weighting coefficient to each of these criteria, sensitivity and specificity were better with the multiple logistic regression model (95% and 98%, respectively) than with the discriminant analysis model. CONCLUSION: Our classification criteria require further evaluation in multicenter prospective studies.

Influence of parental history of hypertension on blood pressure.

AIM: To assess the effect of parental history of hypertension on blood pressure in representative samples from three French populations (MONICA centres of Lille, Strasbourg, Toulouse). METHODS: We screened 1660 males and 1635 females, aged 35-64 years. Subjects were defined as hypertensive if systolic blood pressure >/=160 mm Hg or diastolic blood pressure >/=95 mm Hg or if they were treated by antihypertensive drugs. Four groups of parental history were determined: no parental history; at least one parent hypertensive before 60 years; hypertension was diagnosed after 60; and hypertension with unknown age of discovery. A logistic regression model was used separately for each sex. RESULTS: After adjustment for age, body mass index, physical exercise, educational level, tobacco consumption, alcohol consumption, high density lipoprotein cholesterol, centre, diabetes mellitus and hypercholesterolaemia, parental history before age 60 was related to offspring's hypertension: OR = 2.09 (95% CI: 1.42-3.09) in men, and OR = 2.77 (95% CI: 1.95-3.93) in women. This relationship was stronger when we compared two parental histories versus none (women: OR = 5.33, 95% CI: 1.30-21.94; men: OR = 7.78, 95% CI: 2.45-24.74). CONCLUSION: In this representative cross-sectional study, history of hypertension in at least one parent was associated with offspring's hypertension.