Background Precursors of cardiovascular diseases (CVD) originate in childhood. We investigated the relationship of children's CVD risk-factors with parent's socioeconomic position (SEP) and lifestyle. We also studied how CVD risk-factors correlate within families.

Methods We studied 602 families (2141 individuals) comprising two full sibs; aged 5–14 years, and their biological parents (Uppsala Family Study). Parental SEP measured as occupational class and education, and lifestyle habits (smoking, physical activity, alcohol consumption) were obtained from questionnaires. Associations with cholesterol, apolipoproteins (ApoB/ApoA1), adiponectin, blood pressure, body mass index and overweight/obesity were analysed by linear and logistic regression. Results are adjusted for children's age, gender, pubertal stage and family clustering.

Results In addition to differences in children's CVD risk factors by parental SEP, we observed specific associations between parental lifestyle and children's risk-factors that were independent of parental social characteristics. Children of non smoking parents had lower BMI (difference between children of smoking vs non smoking fathers, 0.8 kg/m², 95% CI 0.1 to 1.4) and children of mothers reporting vigorous physical activity had lower BMI, cholesterol, ApoB/ApoA1 levels and decreased odds for overweight/obesity. Independent and consistently statistically significant associations were found between parents' and children's CVD risk-factors.

Conclusion Parental behaviours like smoking, alcohol consumption, and low physical activity were significantly associated with higher levels of certain CVD risk-factors in children. Strong correlations in CVD risk-factors between family members that are not related to SEP or parental lifestyle suggest a role of genetics in influencing children's CVD risk-factors. Public health policies should target families with unhealthy lifestyles.