Background Coronary heart disease (CHD) risk, and especially the risk of early onset myocardial infarction, shows a strong familial pattern. Associations with other circulatory conditions and overall survival are less well studied. We estimated the associations between age at death of the parents and the risk of 18 prevalent and incident conditions, and mortality, in a large middle-aged UK cohort.

Methods Prospective data from the UK Biobank was available for 189,076 participants aged 55–73 years (including 696 offspring of centenarians). Participants were followed-up from baseline for hospital admissions and mortality (mean period of 6 years and 5.5 years respectively, maximum >8 years for both). We excluded premature parental deaths and parental survival was ranked into short, intermediate and long-lived categories. A combined ranked parental longevity score was created, with a higher score indicating a greater parental age at death. Cox proportional hazards regression models investigated the associations of parental longevity score and the risk of prevalent and incident disease and mortality.

Results At baseline, increasing parents’ age at death was associated with participants being more physically active and having more education and higher income, plus having less obesity and lower rates of smoking. Adjusting for age, sex, ethnicity, education, income, smoking status, alcohol intake, physical activity and body mass index, parental longevity was associated with lower prevalence and incidence of several common circulatory conditions, including peripheral vascular disease (per longevity category Hazard Ratio for incidence: 0.73; 95% CI: 0.64, 0.83), stroke (HR, 0.77; 95% CI: 0.70, 0.86), heart failure (HR, 0.78; 95% CI: 0.70, 0.87), coronary heart disease (HR, 0.86; 95% CI: 0.81, 0.91) and atrial fibrillation (HR, 0.88; 95% CI: 0.82, 0.94). Offspring of longer-lived parents also had a lower risk of all-cause mortality (HR, 0.87; 95% CI: 0.84, 0.91) and a markedly lower risk of CHD mortality (HR, 0.74; 95% CI: 0.65, 0.83). However, the associations with cancer mortality, incident cancers and other conditions were weaker.

Conclusion Data from the UK Biobank provides evidence that the middle-aged offspring of longer-lived parents have markedly lower risks of several common cardiovascular conditions (in addition to coronary heart disease), and all-cause and cardiovascular mortality, and these associations remained after adjustment for several environmental risk factors. Family history of having longer lived parents could enhance risk assessment for a wide range of circulatory outcomes and all-cause mortality, but formal evaluations in representative samples are needed.