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How Family History of Heart Attack Affects You

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WebMD Health News

Sept. 20, 2000 -- Having a parent who had an early heart attack is a well-known risk factor for heart disease, and researchers may now have a better understanding of why that is. It appears that hardening of the arteries begins very early for people who have a genetic predisposition, with significant damage often occurring before age 20.

But inheriting bad genes doesn't mean a person can do nothing to lessen the risk of heart attack or stroke. In fact, these are the people who benefit most from adopting a heart-healthy lifestyle, experts say.

"People with a family history of heart disease have a higher absolute risk, so they actually have a lot more to gain by reducing their risk with lifestyle changes and drug therapy. Someone with this history shouldn't even think about smoking, should make sure their blood pressure and cholesterol is under control, and should avoid obesity, which is strongly associated with diabetes and heart disease," American Heart Association spokesman Harlan Krumholz, MD, tells WebMD.

The cholesterol plaque build-up, which causes the hardening of the arteries known as atherosclerosis, generally occurs as people grow older, and is associated with both heart attack and stroke. Lifestyle influences, such as high blood pressure, high cholesterol, and smoking are critical risk factors in artery blockage, but genetic influences also play an important, but as-yet mysterious, role.

It has been suggested that the risk of heart attack death is as much as seven times higher for those with parents having attacks prior to age 60, compared with the general population.

"What we wanted to know was whether or not there are structural and functional changes in the arteries of the children of a parent who has had a premature heart attack," Gene Bond, PhD, of Wake Forest University School of Medicine in Winston-Salem, NC, tells WebMD. Bond and Wake Forest colleagues collaborated with researchers from the State University of New York at Buffalo and the Federico II University of Naples, Italy, to answer the question. They report their findings in the Sept. 21 issue of TheNew England Journal of Medicine.

Using ultrasound imaging, researchers measured the thickness and function of arteries, two indicators of early hardening of the arteries, in 40 healthy young people (age range six through 30) with a parent who suffered a heart attack before the age of 60; this was considered the high-risk group. They compared them with a low-risk group: 40 similar people with no parental history of heart disease.

On average, at the end of the study subjects' teenage years, the artery walls of the high-risk group were already 11% thicker, and their arteries were functionally about 55% less reactive than the low-risk group, according to Bond.

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