TABLE 4-1

Evidence-Based Recommendations for Use of Family History in Cardiovascular Health Promotion

Birth to 18 yTake detailed family history of CVD at initial encounter and/or at 3, 9–11, and 18 yaGrade B Recommend
If positive family history identified, evaluate patient for other cardiovascular risk factors, including dyslipidemia, hypertension, DM, obesity, history of smoking, and sedentary lifestyle
If positive family history and/or cardiovascular risk factors identified, evaluate family, especially parents, for cardiovascular risk factorsGrade B Recommend
Update family history at each nonurgent health encounterGrade D Recommend
Use family history to stratify risk for CVD risk as risk profile evolvesGrade D Recommend
Supportive action: educate parents about the importance of family history in estimating future health risks for all family members
18 to 21 yReview family history of heart disease with young adult patientGrade B Strongly recommend
Supportive action: educate patient about family/personal risk for early heart disease, including the need for evaluation for all cardiovascular risk factors
  • Grades reflect the findings of the evidence review; recommendation levels reflect the consensus opinion of the expert panel; and supportive actions represent expert consensus suggestions from the expert panel provided to support implementation of the recommendations (they are not graded).

  • a “Family” includes parent, grandparent, aunt, uncle, or sibling with heart attack, treated angina, coronary artery bypass graft/stent/angioplasty, stroke, or sudden cardiac death at <55 y in males and <65 y in females.