Introduction We examined whether the association between lifestyle behaviours and cardiovascular disease mortality is modified by parental history of CVD.

Methods The survey cohort was a total of 52 606 subjects (22 278 men and 30 328 women) aged 40–79 years from 1988 to 1990 were followed-up until the end of 2006. Paternal, maternal, both of parental, and either/both of parental histories of heart disease and/or stroke were defined as parental histories of CVD. We used the healthy lifestyle score (fruits≥1/day, fish≥1/day, milk almost every day, exercise≥5 h/w and/or walking>0.5 h/day, BMI 21–25 kg/m², Ethanol intake<46.0 g/day, non-smoker, and sleep 5.5–7.5 h/day, ranged 0–8) to evaluate the lifestyle status.

Results During the 14.2 median years of follow-up, there were 3284 deaths from total CVD (1706 men and 1578 women). Compared with people without parental history of CVD, those with it showed 9%–25% increased risk of mortality from CVD. However, the association between lifestyle behaviours and the mortality from CVD did not vary materially by parental history of CVD. The respective multivariable HRs (95% CI) in highest lifestyle score category compared to lowest were 0.55 (0.45 to 0.68) for either/both of parental histories of CVD and 0.50 (0.39 to 0.64) for those without it in men, and 0.65 (0.54 to 0.79) and 0.63 (0.49 to 0.81) in women.

Conclusions Lifestyle modifications may be important for both people with or without parental histories.