How does family history affect my risk for heart disease?

You probably know that having parents with early heart problems ups your vulnerability, but did you know that having a sibling with heart disease before age 60 doubles your own odds of trouble? Sharing clothes is one thing, but heart attacks? Tell your doc about this part of your family history, and then do everything you can to stay healthy, from eating whole grains and exercising to not smoking.

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Coronary artery disease runs in families. Many studies have shown that people with a parent who developed coronary artery disease before age 55 face a much higher risk than others of developing heart disease. Estimates of the magnitude vary, but this type of family history is clearly on par with other major risk factors such as high blood pressure and cholesterol.

However, it's important to keep two things in mind. First, not every family history is equally worrisome; it takes a strong history (for example, a father or brother afflicted before age 55 or a mother or sister stricken before age 65) to increase your risk. Second, genetic research into heart disease remains in its infancy, and many questions remain, particularly about which genes are most important in making people susceptible to heart disease and how these genes interact with other genes and lifestyle factors to affect risk.

Heart disease is hereditary in certain groups of patients. Generally, if a man has a heart attack before the age of 45, or a woman before the age of 55, that person’s children are at greater genetic risk of a heart attack. More often than not, family history plays a role in heart disease risk factors, rather than a direct genetic risk for heart attack. That is, if your parents have high cholesterol, then there is also a risk that you will have high cholesterol. The same is true for high blood pressure and diabetes.

If your parents have risk factors for heart disease, some things you can do to lower your risk of heart disease are: 

• Watch your diet.
• Be physically active.
• Keep your weight within a healthy range.
• Avoid risk factors such as cigarette smoking.
• See a doctor for cholesterol and blood pressure monitoring and treatment as needed.

Aggressive treatment of risk factors can lower the overall risk for heart disease and delay its onset.

Family history plays a role in heart disease risk. Your risk increases if your father or brother was diagnosed with heart disease before 55 years of age, or if your mother or sister was diagnosed with the disease before 65 years of age.

However, having a family history of heart disease doesn't mean that you will have it too. This is especially true if your affected family member smoked or had other heart disease risk factors that were not well treated.

Making lifestyle changes and taking medicines to treat other risk factors often can lessen genetic influences and stop or slow the progress of heart disease.

This answer from the National Heart, Lung, and Blood Institute has been reviewed and/or edited by Dr. Robert S. Kaufmann.

A family history of heart disease is indeed a risk factor for heart disease, but it is by no means a definite indication that you will be affected. It actually plays a smaller role than the risk factors you can control, which include smoking, behaviors contributing to type 2 diabetes, weight, activity levels, blood pressure and cholesterol levels.

You have a strong genetic risk if you have a father or brother who was diagnosed with coronary artery disease before age 55 or a mother or sister who developed it before age 65. While your heritage doesn't necessarily consign you to heart disease, it should serve as a signal to be alert for symptoms and to keep other risk factors under control.

A family history of premature heart disease is a major risk factor for cardiovascular disease.  If an individual has a first degree female relative who developed heart disease before the age of 65, or a first degree male relative who developed heart disease before the age of 55, they are at risk.  It is important that anyone with a family history of premature heart disease see a health care professional and have their lipids checked and be screened for other cardiac risk factors.  Identifying and treating one’s risk factors can prevent that individual from suffering the same fate as their relatives.

Family history is a major risk factor for heart disease. Having a parent with a heart attack at an early age (under age 55 if male; under age 65 if female) should be a red flag. It is a risk factor that you can't change. There are, however, several other risk factors that you can change, such as whether or not you smoke, your level of physical activity, and if you eat a healthy diet.