Johns Hopkins researchers report that a new analysis of health information drawn from a national database reaffirms the missed opportunity doctors have in recommending lifestyle interventions to people with a family history of diabetes and cardiovascular disease.

Using data on nearly 11,000 adults 18 and older from the National Health and Nutrition Examination Survey 2009–2012, the investigators concluded that people with a family history of diabetes and/or cardiovascular disease are more likely to be current smokers and overweight compared to those without such history.

The investigators, however, found no such correlations between family history of cardiovascular disease and/or diabetes and lack of exercise, or excessive intake of dietary salt and cholesterol.

The analysis is summarized in the March edition of the journal Preventive Medicine.

“The results emphasize the continuing value of using family history to identify high–risk patients and proactively counseling them to adopt healthier lifestyles because nothing can be done to change the genetic predispositions for heart disease and diabetes reflected in family history,” says Eboselume Akhuemonkhan, MD, MPH, a postdoctoral gastroenterology research fellow at the Johns Hopkins University School of Medicine and the study’s lead author.

She noted that although many physicians calculate lifetime cardiovascular disease risk with an assessment tool called the Framingham Risk Score, the tool does not incorporate family history, which may exclude high–risk individuals from potential preventive behavioral interventions.

Obtaining family history is also easier to obtain than complex risk scores while still leading to similar recommendations — i.e., increasing physical activity, decreasing smoking — adds Mariana Lazo, MD, PhD, ScM, assistant professor of medicine at the Johns Hopkins University School of Medicine and the paper’s senior author.

The data included responses to questionnaires and physical examinations for 10,988 participants who had an average age of 47; 51 percent (5,656 of 10,988) were female and 49 percent (5,332) were male.

The researchers found that 30 percent (3,596 of 10,988), 6 percent (548) and 7 percent (739) of the U.S. adult civilian population self–reported a family history of diabetes, and both diabetes and cardiovascular disease, respectively.

Compared to individuals with no family history, those with family history of diabetes were more commonly non–Hispanic blacks (16 percent) and Mexican–Americans (11 percent). Conversely, those with family history of cardiovascular disease were more commonly non–Hispanic whites (83 percent).

The researchers found no associations between family history and levels of physical activity or cholesterol and sodium consumption. Regardless of family history, they report, two–thirds of all participants failed to meet the threshold for government–recommended weekly physical activity of at least 150 minutes per week, and there were no significant differences in cholesterol and sodium intake.

The analysis specifically found that the prevalence of overweight or obesity was higher among those with family history of diabetes (74 percent), cardiovascular disease (66 percent) or both (80 percent), as compared to those without family history (65 percent).

Similar results were observed for smoking, with those with family history of either diabetes (21 percent), cardiovascular disease (27 percent) or both (28 percent) having a higher prevalence of current smoking compared to those without family history (18 percent). The same trend held true for former smokers. Those with a family history of diabetes (26 percent), cardiovascular disease (24 percent) or both (24 percent) had a higher prevalence of past smoking compared to those without a family history (24 percent).