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The question

My mother has been on beta-blockers for high blood pressure for most of her adult life. I'm a woman, about to turn 36, and have never had any problems with my blood pressure. Should I be worried about heart disease?

The answer

It's good that you're aware of this situation because it is well known that a family history of a first-degree relative with heart disease before the age of 65 years for a female relative can put you at higher risk for heart disease in the future.

Although heart disease is frequently seen as only affecting men, the reality is that it is the No. 1 killer of women as well. Statistics Canada estimates that heart disease accounts for one-third of female deaths each year. With this information, there has been a focused effort to raise awareness among women, as they are affected 10 years later than men, may experience more atypical symptoms (i.e. nausea, dizziness, anxiety, abdominal pain) and have a worse prognosis when they come to the hospital compared with men. Also, women are less likely than men to believe they're having a heart attack and more likely to delay seeking emergency treatment.

The good news is that 80 per cent of heart disease is preventable, and it is never too late or too early to know your risk factors and try to make some positive changes in your life.

Let's try to better understand your risk based on your family history. Hypertension or high blood pressure does run in families and is a major risk factor for stroke, heart attack and kidney disease. It is a chronic medical condition in which the pressure in the arteries is elevated. This results in the heart having to work harder than normal to push blood through your body.

While high blood pressure is not the same thing as heart disease, it is a major risk factor for it.

While the length of time that your mother has been treated is concerning, it would also be important to know if she has other risk factors that may be contributing to her health. Certain conditions such as diabetes, kidney disease and being overweight can contribute to a higher than normal blood pressure. Lifestyle habits such as excessive alcohol use or smoking are also significant contributors to high blood pressure.

Risk factors for heart disease come in two forms: Those that can be changed, and those that are fixed and out of our control.

Non-modifiable risk factors for heart disease include age, gender (males are more at risk than females) and ethnicity (African, Asian, Latin Americans are at higher risk). For women, once they pass menopause the risk equalizes between genders.

The reassuring news is that high blood pressure is a modifiable risk factor for heart disease and can be improved with lifestyle change and medication. The target to aim for to reduce heart disease is below 140/90. If you have diabetes, this number should be below 130/80. To reach these healthy targets, try to maintain a healthy weight, exercise regularly and don't smoke.

While it can cause concern to know that you have an early family history of high blood pressure, use this increased awareness as motivation to improve your health and control the risk factors that you can. By knowing your numbers (blood pressure, cholesterol, weight), being aware of your risk factors and making healthy lifestyle changes you can significantly decrease your chance of heart disease in the future.

Send family doctor Sheila Wijayasingheyour questions at She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.