Heart Health and Your Family History
Genetics play a big role in the health of your heart. What can you do to protect it -- today?
Most people know that cardiovascular disease can run in families -- that if
you have a family history of heart disease, you may be at greater risk for
heart attack, stroke, and other heart problems. But how much does family
history affect your heart health? What parts of the family tree are most
important? And what can you do about it?
Family History and Your Heart Health
Simply put, the closer the relative, the greater your heart disease risk. If
you have a "first-degree relative" -- that's a mother, father, sister,
or brother (or even a son or daughter) who had heart disease at an early age,
that increases your risk of developing heart disease.
"The more family members you have, the higher the potential risk,"
says Roger Blumenthal, MD, director of the Johns Hopkins Ciccarone Center for
the Prevention of Heart Disease. "More than one first-degree relative with
early heart disease doubles your risk, even if you control for other
So what's considered "an early age?" Generally, says Blumenthal,
heart attacks, strokes, and documented cardiovascular disease in a man under
55, or a woman under 65, raise a red flag. The more family members you have,
the higher the potential risks of heart disease.
"If we see multiple first-degree relatives with premature cardiac
events, even if the patient is young and looks otherwise healthy, this is when
we'd consider really aggressive measures to manage cardiovascular risk
factors," says Stanley Hazen, MD, section head for preventive cardiology
and cardiac rehabilitation at the Cleveland Clinic. For example, instead of
shooting for an LDL (bad cholesterol) level of less than 130, your doctor might
want you to aim for 100 or lower.
People with a particularly strong family history of heart disease might be
put on aspirin at an earlier age than normal, or blood pressure medication for
even borderline blood pressure, says Blumenthal. "That's the medication
approach, but such a risk should also motivate you to improve your dietary and
What if your father died of a heart attack in his 80s? That, says Hazen,
shouldn't be considered a risk factor for you. "The fact is that half of us
will experience cardiovascular disease in our lifetime, so you have to consider
where, statistically, the family history looks like it is a significant factor.
Parents having heart disease in their 80s doesn't really qualify."
Distant Relatives and Your Risks of Heart Disease
What's less clear is how more-distant relatives, such as aunts, uncles, and
grandparents, affect your heart disease risk.
"The data isn't as strong, but some suggest it still plays a role,"
says Blumenthal. One study showed that second-degree relatives with
cardiovascular disease are also associated with an increased risk of having a
higher coronary calcium score." A high coronary calcium score suggests
coronary artery disease and can be an early warning sign of heart disease.