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Does being part of a larger family raise cardiovascular risk?

  • A recent study investigated the association between the number and relative age of siblings and the combined risk of fatal and nonfatal cardiovascular events.
  • The results suggest that being part of a larger family with multiple siblings or being a second- or third-born sibling could increase the risk of cardiovascular events.
  • This is the first study involving birth order and family size that also includes the risk of nonfatal cardiovascular events.
According to the World Health OrganizationTrusted Source, cardiovascular diseases (CVD), which affect the heart and blood vessels, are the leading cause of death globally.
Family history and lifestyle factors such as smoking and an unhealthy diet are well-established risk factors for cardiovascular diseases, including coronary heart disease and stroke.
Besides a family history of CVD largely influenced by genetic predisposition, there is also evidence to show that family structure, especially birth order but not family size, can influence the risk of death due to cardiovascular conditions.
However, only a few studies have looked at the impact of family structure on nonfatal cardiovascular events.
A comprehensive understanding of the impact of family structure on CVD risk requires the inclusion of both fatal and nonfatal cardiovascular events.
A large observational study involving people aged 30–58 years at onset now shows that the number of siblings and birth order can influence the risk of total cardiovascular events over a 25-year follow-up period.
A team of researchers led by Prof. Peter Nilsson at Lund University in Sweden conducted this study. Their findings appear in the journal BMJ Open.

Linking family structure to cardiovascular risk

To obtain information about family structure, the researchers used the Swedish Multi-Generation Register (MGR)Trusted Source. The register includes records of biological parents of more than 95% of the population born after 1931 and alive in 1961, thus providing an exceptionally large dataset.
The study included data from 1.36 million men and 1.32 million women aged 30–58 years in 1990. They determined the risk of nonfatal and fatal cardiovascular events as well as total mortality among these individuals using data from death and hospital discharge registers between 1990 and 2015.
Factors such as socioeconomic status, education level, marital status, and medical conditions such as diabetes can influence CVD risk.
The team adjusted their analysis to account for the influence of these variables and attempt to isolate the impact of family structure on cardiovascular events.

Potential impact of family structure

In terms of family size, men and women with more than one sibling were at a lower risk of death than those with no siblings.
Men with one or two siblings had a lower risk of cardiovascular events than those with no siblings, while those with four or more siblings had a higher risk.
Men with three or more siblings also had a higher risk of coronary events compared with no siblings.
Similarly, compared with women with no siblings, women with three or more siblings had a higher risk of cardiovascular events. In addition, women with two or more siblings had a higher risk of coronary events.
In the case of birth order, first-born individuals had a lower risk of cardiovascular and coronary events than those who were born later.
In contrast, first-born individuals had a higher risk of overall mortality than second-born siblings.
Medical News Today spoke with Dr. Randolph P. Martin, FACC, FASE, FESC, emeritus professor of cardiology at Emory University Healthcare in Atlanta, GA, and chief medical officer at Caption Health in Brisbane, CA, about the implications of this study.
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