Familial occurrence of coronary heart disease according to clinical manifestation

Occurrence of different clinical manifestations of coronary heart disease (CHD) was assessed among the parents and siblings of 309 men with CHD (case probands), including 103 men with fatal and 100 with nonfatal myocardial infarction (MI), and 106 men with angina pectoris (AP) and among the relatives of 106 reference men. CHD was equally common among relatives of all case probands. It was four times as common in case brothers and twice as common in case sisters as in the respective reference siblings. There were differences between the various case groups as to the predominant clinical manifestation of CHD. Cardiac deaths were commonest in the sibs of men with fatal MI, and uncomplicated angina in the men with AP. The familial resemblance in the clinical manifestations of CHD suggests familial influence in the mechanisms determining the clinical expression of the disease.