If you have a family history of heart disease, you should proactively consult your doctor to discuss its potential impact on your heart health.
“If a first-degree relative, such as a parent or sibling, suffers sudden cardiac arrest before age 50, your risk of experiencing cardiac arrest yourself is doubled,” says Janet Way, MD, associate professor of cardiology and biomedical sciences at Cedars-Sinai in Los Angeles.
Even if your family’s heart history appears to be relatively normal, if you have a relative with heart disease, you need to know your own risk. These questions will help guide the conversation.
1. How does my family history affect my lifetime risk?
It’s important to ask this question to better understand your own risk for the different types of heart disease that can run in your family.
On the other hand, having a parent or sibling who had a heart attack early on can double your risk of having a heart attack, Dr. Wei says.
Asking this question will help you understand the specific heart health risks you face and how to manage them throughout your life.
2. Should my child be tested?
“Children as young as 2 (years old) should be tested if their parents have high cholesterol levels,” Wei says. “There is a condition called familial hypercholesterolemia, where bad cholesterol is very high, and people with this condition are at increased risk of heart attack and stroke.”
Understanding your child’s risk for heart disease can help encourage a healthy lifestyle and start medications at an early age to reduce the chance of developing heart disease later in life.
3. Is a calcium score test useful?
Calcium scoring (CAC) testing is a painless, low-radiation CT scan that detects calcified plaque buildup within the blood vessels of the heart. This improves our understanding of heart health and risk today. Ask this question if you have a family history of heart attacks or elevated cholesterol levels.
“We recommend this test for people over the age of 35 if they have a strong family history of heart disease,” says Dr. Burka. “We wouldn’t expect to find calcified plaque in a 40-year-old. So if we do find calcified plaque, we can put together a treatment plan that includes statin drugs and aspirin therapy.”
4. Should I get a lipoprotein A test?
Few people ask this question, as most people have never heard of the relatively new Lipoprotein A (LpA) test, but it’s worth asking your doctor.
“If a male parent or sibling had a cardiac event before age 55, or a female relative had a cardiac event before age 65, you can consider measuring lipoprotein A,” Wei says. “Lipoproteins are sticky cholesterol particles that are called an increased risk factor for plaque buildup. Everyone should have them measured at least once in their lifetime, and it may be even more important to do so in people with a family history of heart disease.”
5. Do I need to take aspirin every day?
Low-dose aspirin was once the standard recommendation, but if a close relative has had a heart attack or you know your family history includes heart disease, you may want to start taking aspirin daily. However, the consensus regarding aspirin treatment is changing, so do not proceed without first consulting your doctor.
“You don’t need to take aspirin every day,” Burka says. “While aspirin therapy may be appropriate for certain people with certain types or levels of heart disease, no one should self-medicate with aspirin. Instead, talk to your doctor about the types of treatment that make sense for you, your personal heart health, and the risks associated with your family.”
6. Does kidney disease affect cardiovascular risk?
“According to new guidelines from the American Heart Association, CKD is considered to increase the risk of developing coronary artery disease,” Dr. Burka says. “People with stage 3 or higher CKD may have reason to intensify their statin (treatment) to keep their LDL (‘bad’ cholesterol) below 70. ”
Dr. Burka says other inflammatory diseases, such as lupus and rheumatoid arthritis, can increase your risk of coronary artery disease, so you should discuss your heart health with your doctor.
7. I eat healthy and exercise regularly. Do you still need to worry about your heart health?
Aside from a heart-healthy lifestyle, you should also ask your doctor what heart health tests make sense for you.
“Even if you’re healthy and eating a healthy diet, it’s important to know your heart health numbers, such as cholesterol and blood pressure,” says Wei. “You may have a normal BMI and blood pressure and appear asymptomatic, but if your cholesterol is high, you should consider medications to treat it, especially considering your family’s history of heart disease. If there is a genetic cause, such as high cholesterol, medication is the only way to lower your cholesterol.”
8. Should I get genetic testing for heart attack risk?
With the proliferation of commercial DNA health test kits, you may be wondering if your doctor can order something similar to assess your risk. That’s a pertinent question.
“While there is no genetic test for coronary artery disease per se, there is genetic screening that can be done specifically for familial hypercholesterolemia. In fact, even if you don’t know your family’s heart history, if your regular cholesterol test shows an LDL cholesterol of 190 or higher, it’s a strong indication that it’s hereditary, so it’s worth doing genetic testing.”
9. Should I use a heart health tracker?
Ask your doctor this question so you can focus on the type of health tracker that best fits your goals, rather than becoming overwhelmed by the numerous apps and devices available.
For example, if you’ve been diagnosed with high blood pressure, it might be a good idea to invest in a home blood pressure monitor, says Wei. “It connects to your blood pressure app, so you can easily call it up when you’re in the doctor’s office,” she says.
Burka also likes fitness watch trackers. “Among the technologies we recommend to our patients are step trackers to encourage people to stay active,” she says.
takeout
- Understanding your family’s heart history is very important. Having a first-degree relative who has had an earlier cardiac event can double your risk, so you should be proactive in discussing your lifetime risks with your doctor.
- Ask about specific diagnostic tools, such as a CAC test to detect plaque buildup, an LpA blood test, or even screening for children if hypercholesterolemia runs in the family.
- It is important to discuss how non-cardiac diseases such as chronic kidney disease and inflammatory diseases such as lupus act as risk enhancers that may require more intensive treatment.
- Even if you live a heart-healthy lifestyle, it’s worth asking your doctor about your risk and new habits that can help improve it.
