Cardiovascular disease continues to be a major cause of death in India. While efforts are being made to decrease the risk factors for heart disease, one area that remains elusive is the family medical history. Yes, heart disease could be linked to our genes and family history remains a key, but most complicated, risk factor for heart disease.
An adverse cardiac family history is generally defined as the detection of heart disease before the age of 55 in male members and 65 years in female members, either siblings or parents. Such history increases the risk of heart disease in an individual and warrants more aggressive preventive measures.
The risk may be due to genetic factors or due to shared lifestyles. The major risk factors for heart disease like Diabetes, Hypertension, Cholesterol abnormalities and Obesity also run in families and may contribute to the added risk. Steady diet of fast foods, chewing and/or smoking of tobacco is another risk factor, which although not strictly related to family, have societal roots. For example, growing up in a household of smokers or one that steadily consume a lot of fast-food meals can also be an influence. While eating habits, chewing or smoking including other shared lifestyles can be altered, we still have to confront our genes.
How can we detect the Risk?
Some medical tests help identify our risk with more accurate diagnosis. A DNA test would be able to give us a score (low, moderate or high) classifying our genetic risk for heart disease. However, a comprehensive heart screening sometimes called the Healthy Heart Package will help determine if we are a victim of hereditary heart disease.
So, what can be done about it?
Understanding whether our family has a history of heart disease may be an indicator to our inherited risk. The first step to adverse family history is to check within our first-degree relatives (father, mother, siblings). Whether anyone have had a heart attack, stroke and die of these at an early age—55 years of age or before for male, 65 or before for women? We can also check for our grandparents, if they suffered from heart disease at early age. Home environment and shared lifestyle of our family can raise our risk too.
However, adoption of preventive lifestyle and health-checks can be the right approach to adverse family history. Lifestyle measures should focus on:
- Regular exercise: The best way to strengthen our heart is by exercising. Regular moderate intensity cardio exercises and strength training improves circulation and our heart’s health. It also help maintain a healthy weight. Moderate intensity aerobic exercises like cycling, jogging, swimming, sports activities with periodic resistance training can be a great help in reducing the risk of heart disease..
- Avoidance of tobacco: Known for causing cancer, smoking and/or chewing tobacco increases the risk of Heart Disease, such as heart attack, stroke including peripheral arterial disease. Smoking affects the arteries that carry blood to our heart and other parts of our body. It damages our artery walls by reducing the amount of oxygen in our blood. Smoking makes our blood ‘stickier’, which causes our blood cells to clump together thus, slowing the flow of blood through our arteries and making blockages more common. These blockages might to heart attack and stroke. So, quit now, if you smoke!
- Normal body weight: Being overweight or obese increases the risk for a number of health conditions like diabetes, high blood pressure, high cholesterol, including heart disease. Carrying extra weight, especially around our middle, is a health risk, so it is important for us to lose those extra kilos if that’s the case. To achieve a healthy body weight, regular physical activity is a must. Physical activity burns up extra energy from our body and balances the energy coming into it (through foods and drinks).
- Good control of cholesterol: While we need some good cholesterol (HDL) to protect against heart disease, too much of bad cholesterol can lead to heart disease. Most of the total cholesterol in our blood is made up of bad cholesterol (LDL). Only a little part is made up of good cholesterol (HDL). High blood cholesterol is primarily caused by consuming foods that are high in trans fats and saturated fats. One should aim for higher HDL cholesterol and low LDL cholesterol. You can achieve this by simple dietary modifications and exercise.
- Blood sugar: Blood sugar or Diabetes is defined as high-level of sugars in our blood — when the body does not make enough insulin or cannot use its own insulin as it should, or both. Also a hereditary condition, diabetes increases our risk for heart disease. If your blood sugars are high, managing it lifestyle changes, exercise and planned diet is mandatory.
- Blood pressure: Our blood pressure might go up and down throughout the day, depending on what we are doing. When this pressure is too high, and stays high over a period of time, it can damage the body severely. High blood pressure is defined as more than 140/90 on two different occasions on different days. Normal blood pressure is 120/80 mmHg regardless of any age. Uncontrolled high blood pressure, if left untreated, can lead to many heart complications like a heart attack, stroke and/or heart failure. People with high blood pressure will have to make healthy lifestyle modifications to prevent heart disease.
In addition to the above, awareness of health through health education and consumption of adequate fruits and vegetables with avoidance of excess salt also helps prevent heart disease. Furthermore, regular healthy heart check-up should be a part of the routine for any person prone to heart disease owing to his/her genes. The Heart Healthy Package should include cholesterol, blood sugar and blood pressure measurement. One should be aware of symptoms of health disease and take prompt consultation if symptoms are suggestive
An adverse family history is considered a non modifiable cardiac risk factor, but preventive steps can help you circumvent it.