Heart Luck: Family History Is Important

If your father or mother has heart disease, that doesn't mean you will automatically develop it, too. It's true that you are more likely to get it than someone who does not have a family history of heart disease, but you can take steps to try to prevent it.

"In a majority of people with a family heart history, we can identify at least one problem they can do something about," says Daniel Rader, M.D., associate professor of medicine at the University of Pennsylvania.

How do you know if you have a family history of coronary heart disease? If a grandfather, father or brother began having symptoms of heart disease -- angina or heart attack -- before age 45, or a grandmother, mother or sister had symptoms before age 55, you have a family history that contributes to your risk.

A family history of heart disease is only one of the risk factors, according to the American Heart Association (AHA). Some risk factors you can change; others, like family history, you can't.

"What family heart history does is identify people who need to be more attentive to their risk factors in the present," says Margo Ann Denke, M.D., associate professor of internal medicine at the University of Texas Southwestern.

Family history, gender and age are all risk factors that can't be modified. Men typically die of heart disease at a younger age than women. About four out of five people who die of heart disease are 65 or older, the AHA says. And some people inherit a gene that causes the liver to create too much blood cholesterol, a fat-like substance that can clog coronary arteries.

Lifestyle can be "inherited" just as much as genetic code. "People may actually get heart disease from their family, but not because of genetic factors," says Martin Sullivan, M.D., executive director of the Institute for Healing in Society and Medicine. "It's often because their mother and father taught them how to eat the foods they eat and how to have the stress they have."

Whether your family's heart history comes from genes or your family's habits, the strategy for prevention is a heart-healthy lifestyle. The AHA recommends that people get screened for their risk of heart disease beginning at age 20. Screening includes measuring blood pressure, body mass index, waist circumference and pulse every two years. Cholesterol levels and blood sugar should be measured at least every five years.

Here are some changes you can make to help prevent heart disease:

• Keep your total blood cholesterol level low. If your total cholesterol level decreases, your chance of having progressive heart disease goes down. The AHA recommends that your total blood cholesterol count be below 200 mg/dL.

• Reduce fats and dietary cholesterol. If you do not have heart disease, the AHA recommends that your daily diet contain less than 10 percent saturated fat and less than 300 mg of cholesterol. If you have heart disease, saturated fat should make up less than 7 percent of your daily diet; you should consume less than 200 mg of cholesterol each day.

• Maintain a healthy weight. People who are overweight or obese are more likely to develop heart disease, the AHA says, even if they have no other risk factors. Excess weight makes the heart work harder. It raises blood pressure and levels of blood cholesterol and triglycerides. You should maintain a body mass index between 18.9 and 25 for optimal health and to reduce your risk for heart disease and certain cancers.

• Don't smoke. Smoking promotes heart disease by damaging arteries, reducing the level of HDL ("good") cholesterol in the body and perhaps by encouraging blood clots in constricted coronary arteries. Nicotine, says the AHA, also temporarily increases your blood pressure and heart rate. Also, try to avoid exposure to secondhand smoke, as well.

• Exercise. Experts recommend 30 minutes of moderate exercise on most days of the week. Exercise raises the level of good cholesterol and helps reduce the excess weight that can raise total cholesterol levels.

• Get treatment for hypertension or diabetes. Each of these can further the progression of heart disease, the AHA says, but both can be controlled by a combination of diet, exercise and medication.

• Ask your doctor about taking aspirin. It inhibits blood clotting and helps retard the progression of heart disease, the AHA says. Many cardiologists recommend half an adult aspirin daily for men over 50.

• Limit alcohol intake.Too much alcohol can raise blood pressure and help boost triglyceride levels, the AHA says. Moderate amounts of alcohol may lower the risk for heart disease, but experts don't recommend that nondrinkers start drinking. A moderate amount of alcohol is no more than two drinks a day for men, and one a day for women. One drink is 12 ounces of beer, 4 to 5 ounces of wine or 1-1/2 ounces of liquor.

• Reduce your stress. Hostility, isolation and anxiety can contribute to heart disease, says Dr. Sullivan. As stress busters, he recommends exercising, finding more leisure time and practicing relaxation techniques.