Dr.S.Venkatesan MD

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.

Final message

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.