Do you have a strong family history of cardiovascular problems? Take heart! You’re not doomed by your genetics.
Every time you see a new doctor or fill out a health information questionnaire, you dread the question. “Do you have a family history of heart disease?” You answer yes and wonder when — not if — you will develop it yourself. After all, you know heart disease is hereditary. Medicine has known that for many years.
“Genetics certainly is part of what puts you at risk for heart disease,” says Martha Gulati, M.D., a cardiologist and the editor-in-chief of the American College of Cardiology’s patient education and empowerment initiative, CardioSmart.org. “And there’s not one unique marker. There are 50 or so that seem to be the strongest indicators of heart disease. We have probably not even identified them all yet.”
Having some of those genetic markers makes it more likely for someone to have high cholesterol; other markers increase a person’s risk of high blood pressure, diabetes and obesity. All of them increase your risk for heart disease to some degree. Heart disease also tends to run in families because of shared lifestyle habits. In other words, if your parents ate a high-sodium, high-fat, high-sugar diet, you’re more likely to eat the same.
“The foods that were cooked for you, the emphasis on physical activity — there’s more to familial heart disease than just your genetics,” Gulati says.
There’s also more to heart disease risk than just family history.
Fitness Over Family History
Just because your family history puts you at greater risk for heart disease doesn’t mean you’ll develop it. In fact, a recent study published in The New England Journal of Medicine (NEJM) showed that lifestyle factors can overrule heredity. The study found that making even a relatively modest effort to live healthfully can cut your risk for heart disease by up to 50 percent.
The study looked at four factors and their effect on heart disease risk: not smoking, maintaining a body mass index (BMI) of less than 30, getting regular physical activity and eating a healthy diet.
“The study showed even people with the highest genetic risk could cut their risk in half by doing three out of the four things,” says Nisha Jhalani, M.D., the director of the Women’s Heart Health Initiative at the Cardiovascular Research Foundation. “It supports what doctors have been telling patients for years — that you can balance the things you can’t change with healthy behaviors you can change.”
And you don’t need to transform your whole life to benefit.
“When the study authors talked about healthy lifestyle, the way they diagnosed it was very liberal,” Gulati says. “Risk was reduced with weekly physical activity, a general healthy eating pattern, not smoking and not being obese. Being overweight (having a BMI between 25 and 29.9) was okay.”
Board-certified interventional cardiologist David Harshman, M.D., of Beaufort Memorial Cardiology suggests that the most important thing you can do, though, is to not smoke.
“Smoking affects your entire vascular system, not just your heart,” he says. “It increases your risk of suffering a heart attack and heart failure, as well as stroke and peripheral artery disease.”
Other Ways to Reduce Risk
While the NEJM study didn’t look at the following factors, research suggests they, too, are beneficial in reducing risk of heart disease.
Get enough sleep. “Poor-quality sleep increases blood pressure, an important risk factor for heart disease,” says Harshman. “Aim for six to eight hours per night of quality sleep.”
Manage diabetes. Uncontrolled diabetes damages blood vessels, making you more susceptible to heart disease. You’re also more likely to have a heart attack without realizing it, as diabetes can damage nerves that signal pain. Keep your blood glucose levels under control.
Ask about medication. If diet and exercise aren’t enough to reduce your blood pressure or cholesterol, talk to your doctor about prescribing medication.
Reduce stress. “Stress doesn’t directly cause heart disease,” says Harshman, “but it can increase the likelihood you’ll engage in other risk factors such as smoking, drinking, overeating and being inactive. Learn to alleviate stress in healthy ways, such as deep breathing, exercising or simply taking time to relax.”
Are You at Risk?
Learn more about Beaufort Memorial’s cardiovascular screenings and spectrum of cardiac and vascular care.