Vascular Inheritance : Father has a TIA . . .on follow up . . . Son develops a full fledged stroke !
Posted May 20 2012 9:02am
Sons are too glad to inherit wealth from their father . But destiny maintains a fine balance . It makes sure they do inherit adverse biological events as well .
A 68 year old man who had a TIA and was completely evaluated . Except for a mild elevation of systolic bl0od pressure and dyslipidemia (Hgh TGL) other parameters were normal. Carotid vertebral Doppler study were normal even though the Intimal-medial thickness was borderline. His CRP was normal . His neurologists warned him about possibility of recurrent TIA or cardiac events and prescribed statins /Amlodipine .
Even as every one was worried about their father his eldest son aged 44 developed a full fledged stroke just a month later !
What is the inference and final message ?
The vascular risk is a continuum .The risk is transmitted vertically to the family members. After all , the father and son share at least 30 % of vascular endothelium by means of structural and genetic blue print.
”Father’s Aorta could continue as son’s carotid artery ! (What a crazy statement ! )
So , whenever you have an elderly man with a vascular event , screen entire family and preferably start vascular prophylaxis. The problem with vascular inheritance is , the children may be conferred more or less risk . The exact quantum can not be predicted.
Beware , children can inherit diseases form their parents even before the parent manifest the full expression of the index disease.It was an example of instantaneous inheritance here .
The irony is complete as the father develops warning shots (TIA) and the son suffers permanent damage (Stroke )
We can’t expect genes to behave in rational way . More importantly genes do get modified with environment in a significant fashion. What is preventing two biological system created by same genes one goes for full-blown vascular event other escapes with a minor event . One simple explanation is , while vascular aging is physiological , the younger vascular system faces much more stress and strain due to altered living conditions.