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Family History of Cardiovascular Disease, Perceived Cardiovascular Disease Risk, and Health-Related Behavior: A Review of the Literature

Imes, Christopher C. PhD; Lewis, Frances Marcus PhD, FAAN

The Journal of Cardiovascular Nursing: March/April 2014 - Volume 29 - Issue 2 - p 108–129
doi: 10.1097/JCN.0b013e31827db5eb

Background: More than 82 million Americans have 1 or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD, and health-related behavior is poorly understood.

Objective: The objective of this article was to review and summarize the published research on the relationship between an FH of CVD, an individual’s perceived risk, and health-related behavior to make recommendations for clinical practice and future research.

Methods: A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between an FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. A total of 238 were excluded, resulting in a total of 25 articles included in the review.

Results: There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between an FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent.

Conclusions: A person’s awareness of his or her FH of CVD or his or her own risk for CVD is not a sufficient predictor of changes in his or her health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with an FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk.

Christopher C. Imes, PhD Postdoctoral Fellow, School of Nursing, University of Pittsburgh, Pennsylvania.

Frances Marcus Lewis, PhD, FAAN Professor, Family and Child Nursing, School of Nursing, University of Washington, Seattle.

Funding sources: grant 5T32NR007106 from the National Institute for Nursing Research of the National Institutes of Health and grant T32NR009759 from the National Institute for Nursing Research of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Correspondence Christopher C. Imes, PhD, School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria St, Pittsburgh, PA 15261 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins