What is a family history of PAD?
You have a family history of peripheral artery disease if your parent, brother, sister, or child has been diagnosed with PAD. A family history of PAD increases your risk of developing the disease.
How does my family history put me at risk?
Heart and blood vessel diseases, including PAD, tend to cluster in families. This is because atherosclerosis, the buildup of fatty plaque on the walls of the arteries, is caused by genetic and environmental factors that family members often share. Genes you inherit from your parents and share with your brothers and sisters can predispose you to developing PAD risk factors, such as diabetes, high blood pressure, and high cholesterol. In addition, families often share unhealthy lifestyle habits such as smoking, lack of exercise, and poor diet.
How does my family history affect my risk of PAD?
A family history of PAD makes you more likely to develop PAD, even if you do not have other risk factors.1
The Framingham Offspring Study tested 2,286 patients (52% were women) from 999 families for PAD in the legs using the Ankle-Brachial Index. The researchers determined that family history was responsible for about one-fifth (21%) of a person's total PAD risk.2 Other studies have produced similar estimates, and found that the heritability of PAD is similar in both African Americans and whites.3
PAD is just one manifestation of atherosclerosis, a disease that affects all the arteries in your body. Because of this, a woman may be at increased risk for PAD if she has a family history of any kind of heart and blood vessel disease, not just PAD. Studies have found that women with a family history of early heart disease are more likely to develop carotid artery disease than women with no family history of heart problems, even after other risk factors are taken into account.4,5
Aortic aneurysms also have a genetic component in some people, and you are at increased risk if you have a family history of aortic aneurysms. One in four people with an abdominal aortic aneurysm (AAA) have an immediate relative with the disease.6
Why is family history important if I cannot change it?
Even though you cannot change your family history, it is important for women with a family history of PAD to lower their risk by focusing on the risk factors they can change. Most women with a family history of PAD have at least one other risk factor that they can control. Risk factors are often inherited, and knowing which ones run in your family can help you target those for which you are at highest risk.
Women with a family history of aortic aneurysms are at high risk for developing one, and should be screened so that an aneurysm can be detected and treated early.7 Medicare covers a one-time screening for women with a family history of AAA as part of the Welcome to Medicare exam.
Recording your family history is an important step towards controlling your PAD risk and protecting your cardiovascular health. One large survey found that although 96% of people believe that family history is important for their own health, fewer than 30% have collected health information from their relatives to develop a family health history.8
How do I record a family health history?
Several online tools can help you collect and organize a useful family history. The US Surgeon General's My Family Health Portrait allows you to create and print a personalized family health history report. See the links below for more information and tips on how to collect your family history.
For More Information:
National Society of Genetic Counselors: Family History
US Surgeon General's Family History Initiative
Centers for Disease Control and Prevention Family History
- McDermott MM, Lloyd-Jones DM. The role of biomarkers and genetics in peripheral arterial disease. J Am Coll Cardiol. Sep 29 2009;54(14):1228-1237.
- Murabito JM, Guo CY, Fox CS, D'Agostino RB. Heritability of the ankle-brachial index: the Framingham Offspring study. Am J Epidemiol. Nov 15 2006;164(10):963-968.
- Kullo IJ, Turner ST, Kardia SL, Mosley TH, Jr., Boerwinkle E, de Andrade M. A genome-wide linkage scan for ankle-brachial index in African American and non-Hispanic white subjects participating in the GENOA study. Atherosclerosis. Aug 2006;187(2):433-438.
- Stensland-Bugge E, Bonaa KH, Joakimsen O. Age and sex differences in the relationship between inherited and lifestyle risk factors and subclinical carotid atherosclerosis: the Tromso study. Atherosclerosis. Feb 1 2001;154(2):437-448.
- Wang TJ, Nam BH, D'Agostino RB, et al. Carotid intima-media thickness is associated with premature parental coronary heart disease: the Framingham Heart Study. Circulation. Aug 5 2003;108(5):572-576.
- Lawrence PF, Wallis C, Dobrin PB, et al. Peripheral aneurysms and arteriomegaly: is there a familial pattern? J Vasc Surg. Oct 1998;28(4):599-605.
- U.S. Preventative Services Task Force. Screening for Abdominal Aortic Aneurysm: Recommendation Statement. Rockville, MD.: Agency for Healthcare Research and Quality; 2005. AHRQ Publication No. 05-0569-A.
- Centers for Disease Control and Prevention. Awareness of family health history as a risk factor for disease - United States 2004.