Heart Disease Runs in the Family: How Worried Should You Be?

January 15, 2017

by Cathe Friedrich

It pays to be aware of your family history. Knowing the health history of family members will tell you whether you should be screened for a specific health problem at an earlier age. However, just because a health condition is in your family doesn’t necessarily mean you will get it. That’s particularly true of heart disease. Although having a strong family history of heart disease, increases your risk, cardiovascular disease is also a lifestyle illness and one that responds to diet and lifestyle interventions. In fact, there’s a new area of medicine called preventive cardiology that focuses on preventing heart disease and taking action through lifestyle and, sometimes, medications to keep your heart healthy.

Family History and Heart Disease

Before assuming you’re at high risk of heart disease because your grandmother and great aunt had heart attacks, look at the bigger picture. There are different “degrees” of family history. Cardiovascular disease is the most common cause of death and one out of two people will die of heart disease. That means somewhere in your family tree, a few people probably suffered a heart attack or stroke. That doesn’t necessarily place you at high risk. What’s more concerning is when multiple family members had cardiovascular disease or a heart attack or if you have relatives that had a heart attack earlier in life. It also matters how close these relatives are to you in the family tree.

According to the World Heart Federation, if you have a first-degree relative who’s male (father or brother) who had a heart attack before age 55, you’re at higher risk of having one as well. Also, if you have a first-degree female relative (mother or sister) who had a heart attack before age 65, your risk is greater. A family history of stroke is also a heart disease risk factor. Having second-degree relatives (grandparents, aunts, uncles) with heart disease or stroke also boosts your risk but not as much.

Other Risk Factors for Heart Disease

Genetics aren’t the only risk factor for heart disease. Here are others you should be aware of:

· Being overweight or obese

· Leading a sedentary lifestyle

· Lipid abnormalities (high LDL-cholesterol & low HDL-cholesterol) or elevated triglycerides

· Smoking

· High blood pressure

· Diabetes or pre-diabetes

· Stress

· Age – risk goes up after menopause in women

There’s another one you should know about. Experts now acknowledge that low-grade inflammation damages blood vessels and is a risk factor for heart disease. Most health care professionals don’t routinely screen for inflammation. However, a blood test that measures c-reactive protein (CRP), an inflammatory marker, can identify ongoing inflammation. If you have a strong family history or have two or more risk factors for heart disease, talk to your doctor about getting a blood test to measure CRP level.

Most people have at least one risk factor for heart disease but the more risk factors you have, the greater your chance of developing cardiovascular disease. Your doctor can calculate your heart disease risk based on your family history, lipids, blood sugar, blood pressure, body weight, etc. If you are, indeed, at strong risk of developing cardiovascular disease, you’ll need to follow your lipids, blood pressure, and blood sugar, closely. Your doctor may also recommend medications to bring these values under control if lifestyle changes aren’t enough. At some point, your doc may also recommend noninvasive testing like a stress test or electrocardiogram to look for evidence of heart disease.

What about Statins?

These days, you hear a lot about statins for the prevention of heart disease but they’re not without controversy. Despite their side effects, statins can be lifesaving for certain subsets of people. However, they’re usually not appropriate for people at lower risk of heart disease, especially when lifestyle changes can reduce the risk. However, if you have a number of risk factors for heart disease or have had a heart attack or stroke, statins are standard therapy. In people at very high risk, a combination of statins and lifestyle changes can be highly effective.

Statins seem to work not only by lowering cholesterol but by reducing inflammation within the walls of blood vessels. Inflammation damages the delicate lining of arteries and makes it easier for a deadly clot to form and block the vessel. Therefore, statins may lower your risk of heart attack in more than one way. If you’re at high risk of heart disease, talk to your health care provider about the pros and cons of taking a statin. For some individuals, the benefits outweigh the potential side effects – but don’t take one without asking lots of questions and understanding why you need one. Even if you decide to take one, lifestyle is STILL important.

If You Have a Strong Family History of Heart Disease

If you are at higher risk of heart disease based on the above criteria, there’s a lot you can do to lower your risk. Genetics are NOT destiny, particularly when it comes to heart disease. Although you can’t change your genes, the DNA blueprint inside your cells, we now know you can impact whether some genes are expressed. Expression of genes is modified by adding chemical groups called methyl groups to activate or silence genes. Diet and lifestyle impact epigenetic expression or methylation. By eating a heart-healthy diet and exercising, these “bad” genes may not be turned on. So, lifestyle matters for a number of reasons and if you’re at higher risk for heart disease, establish an action plan by adopting these heart-healthy habits:

· Avoid processed foods & foods with added sugar

· Maintain a healthy body weight

· Exercise, including some aerobic exercise

· Follow and control your blood pressure through lifestyle or medications, when necessary

· Follow and control your blood sugar.

· Don’t smoke or overuse alcohol

· Eat a handful of nuts each day (linked with lower cardiovascular and overall mortality)

· Eat a diet rich in omega-3s to reduce inflammation. Spices such as turmeric, garlic, and ginger also have anti-inflammatory properties.

The Bottom Line

It’s empowering to know that lifestyle strongly impacts heart health. If you have a family history, be aware and be proactive in doing the things that will lower your risk. Take care of your heart!

References:

Centers for Disease Control and Prevention. “Family History and Other Characteristics That Increase Risk for Heart Disease”
National Heart, Lung, and Blood Institute. “Who Is at Risk for Heart Disease?”
World Heart Federation. “Family History”
American Heart Association. “Family History and Heart Disease, Stroke”