The paired tests identified hidden heart disease among one in five seemingly healthy adults ages 30 to 59 who had a brother or sister with heart disease, according to results published in the Feb. 11 issue of Circulation, an American Heart Association journal.
"Although we already know the risk of siblings developing coronary artery disease is much higher than that of the general population, current guidelines do not target such families for aggressive preventive efforts," says lead author Roger S. Blumenthal, M.D., Johns Hopkins' director of preventive cardiology. "Aggressive testing clearly identifies individuals with hidden heart disease."
Researchers screened more than 700 siblings of heart disease patients, collecting their health histories, doing physical exams and identifying their risk for heart disease on a standardized scale. They also evaluated the siblings' performance during exercise stress tests, measuring heart rate, blood pressure and the heart's electrical function. Most of the siblings were middle-aged, male and white with varying levels of education.
For this study, doctors also used thallium scintigraphy, a two-dimensional imaging test that measures the amount of blood flow through the heart during exercise, showing whether the vessels expand normally to allow more blood to reach the heart. In this test, a radioactive dye is injected just before stopping exercise; afterward, the patient lies on a table while the doctor moves a small camera over the chest, recording signals sent out by the dye and translating them to computer images.
Of the 734 siblings screened, 153 (21 percent) had an abnormal exercise test, scintigram or both, of whom 105 were refer
Contact: Joanna Downer
Johns Hopkins Medical Institutions