Young adults with family history of coronary heart disease have increased arterial vulnerability to metabolic risk factors -: The cardiovascular risk in Young Finns study

Objective - Subjects with family history for coronary heart disease (CHD) may be more susceptible to the adverse effects of risk factors than subjects without family history. We investigated the occurrence of subclinical atherosclerosis in young adults with family history of CHD and tested the hypothesis that their arteries are more vulnerable to the proatherogenic effects of metabolic risk factors. Methods and Results - Carotid artery intima-media thickness (IMT), carotid artery compliance (CAC), and brachial artery flow-mediated dilation (FMD) were measured in the 21-year follow-up of the Cardiovascular Risk in Young Finns Study in 2265 white adults 24 to 39 years of age. Subjects with positive family history of CHD had greater IMT compared with those with negative history (mean +/- SEM; 0.600 +/- 0.006 versus 0.578 +/- 0.002 mm; P = 0.003, respectively). No differences were observed in CAC or FMD (both P > 0.2). The difference in IMT remained similar after adjustment with current risk factors (P = 0.008) or childhood risk factors measured 21 years earlier (P = 0.002). The number of metabolic risk factors (components of the NCEP metabolic syndrome) correlated more strongly with IMT in subjects with family history of CHD than those without (P = 0.007 for interaction). Conclusions - Young healthy adults with family history of CHD have increased carotid IMT. This is partly explained by their increased vulnerability to metabolic risk factors.