Rebooting Family History

Background Heart disease, the primary cause of mortality in America, affects one in five individuals. Heart disease has strong genetic links and is significantly influenced by family history. Aim This study explored family history of premature heart disease, examining the differences between patients' perceptions of risk and actual risk stratification, in overweight and obese individuals seeking Advanced Practice Nurse care. Methods The descriptive, cross-sectional study involved a convenience sample of 175 subjects at least 40 years of age. Respondents indicated their risk of premature heart disease, following completion of a family history questionnaire. They were then risk stratified by Scheuner's( 1997) scale of genetic risk. Results The majority of respondents (62.4%) rated their risk of premature heart disease, based on family history, as only average or moderate, but 54.5% were classified as high risk using risk stratification. Of those respondents whose actual risk was high, a third perceived their risk to be moderate, and a quarter considered their risk to be only average. Conclusions The significant underestimation of risk [p<.004] suggests that people fail to understand the important relationship between family history and premature heart disease. Advanced Practice Nurses can play a critical role in interpreting, translating, and framing familial risk. Underestimation of familial risk accounts for a significant portion of CVD risk. Genetic susceptibility is not health destiny. Interpretation of familial risk provides the perfect segway to individualizing and informing preventive strategies, potentially impacting individual and family health.