Life

Family history of heart disease? Here's what you need to know

It's a good idea to know if cardiovascular problems such as heart disease run in your family – but lifestyle factors also play a key role from an early age. Abi Jackson finds out more

It's never too early to start developing a heart-healthy lifestyle
Abi Jackson

IT'S always alarming when a loved one develops cardiovascular disease or suffers a heart attack. As well as worrying about them, it might make you consider your own health too – especially as these things can run in families.

So, if you do have a family history of heart disease and stroke, how concerned should you be? And what can you do about it?

We talked to Dr Gerald Carr-White, a consultant cardiologist at Guy's and St Thomas' Hospital, as well as London Bridge Hospital, part of HCA Healthcare UK (londonbridgehospital.com), and Philippa Hobson, a senior cardiac nurse for British Heart Foundation (bhf.org.uk).

:: How important is family history for heart health?

Around 7.5 million people are living with heart and circulatory disease, according to British Heart Foundation, and even though treatments have generally improved, cardiovascular disease remains a leading cause of death in the UK and Ireland. Family history can be very relevant – but it's important to remember this is part of a bigger picture.

Generally, "the most common thing that tends to run in families is vascular disease, affecting the coronary arteries", says Dr Carr-White. Known medically as 'atherosclerosis', heavily clogged, blocked or narrowed arteries are a recognised cause of potentially life-threatening heart attacks and stroke. It occurs due to a build-up of fatty deposits which, over time, leads to plaque developing within the artery walls.

Family history is one of five or six important risk factors that come into play, says Carr-White: "The others are whether you smoke, whether you've got a healthy diet, whether you exercise. There's also high blood pressure, diabetes, high cholesterol to consider. All of these are very important."

:: Find out what's actually going on

The first step is to try and have a general awareness of your family history, and if you are concerned, Hobson says it's a good idea to "ask questions about what happened". Did doctors specify a cause? How old were they when it first happened?

"If your granddad or dad was in their 60s or 70s then of course that's still a serious thing, but if there is a family history of very premature heart attack, then you might want to take a more serious look at things like high cholesterol in the family," says Hobson. "Some people may even be born with high cholesterol but just not know about it until something happens."

For example, familial hypercholesterolaemia, a genetic condition that affects around one in every 250 people, causes abnormally high cholesterol from a young age.

"It's also worth pointing out that a lot of the time when people die young or suddenly, while it's is often put down to a heart attack, this can sometimes be due to inherited conditions within the muscle or electrics of the heart," adds Carr-White.

So, if you do have a family history of people dying at a young age, particularly if it's below 40, it's worth going for a check-up with a specialist to see if there is anything else running through the family."

:: Healthy lifestyle habits go a very long way

Understandably, knowing heart problems run in your family can be worrying. "Family history is what's called an 'unmodifiable risk factor'," says Hobson – but that doesn't mean future heart problems are inevitable.

"We can't help our family background, but many of the other key risk factors are modifiable. So, it's really about addressing the other risk factors."

Lifestyle plays a vital role here. "Lifestyle measures are the most important thing anyone can do, and probably make more of a difference than anything else," says Carr-White.

"So keep an eye on your weight, don't smoke, exercise regularly, eat a healthy diet – that probably does more good than all the tablets put together."

This is important for everyone, regardless of family history. For those of us who are more genetically predisposed to developing problems, Carr-White notes that a healthy lifestyle "can make a difference to when those problems present". In other words, we could help delay them – and sometimes prevent them entirely – by living healthily.

Try to adopt a 'Mediterranean diet' rich in fruit, vegetables and oily fish, cut your salt intake and get regular exercise.

There's also growing evidence on how diet and lifestyle in childhood impacts health in later life – so it's never too early to start encouraging healthy habits.

"If you look at the aortas and arteries of adolescents, you can see the early stages of problems with the walls of the arteries," says Carr-White.

"So getting those lifestyle habits in from an early age is a good idea."

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