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Heart disease runs in my family - but I'm healthy

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The question

If heart disease runs in my family, but I'm healthy - at a healthy weight with normal blood pressure and cholesterol. Do I need to worry?

The answer

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Despite having a healthy blood pressure and cholesterol level, your concern regarding family history is a valid one . A family history of a first-degree relative with coronary heart disease or stroke before the age of 55 (for a male relative) or 65 years (for a female relative) puts you at higher risk of heart disease in the future.

(Heart disease is an umbrella term that describes many conditions including diseases of the valves, muscles and arteries of the heart, which needs oxygen to stay alive. When blockage occurs part of the muscle can become injured or die, which causes angina or a heart attack.)

80 per cent of heart disease and stroke is preventable and it's never too late or too early to know your risk factors and try to make some positive changes in your life. Risk factors for heart disease come in two forms: those that are modifiable or can be changed and those that are fixed or out of our control.

In addition to a family history of heart disease, other risk factors that we can't change include:

• Age: As we get older, our risk of heart disease increases.

• Gender: Men have a higher risk of heart disease than pre-menopausal women. Post menopause, this risk equalizes between the sexes.

• Ethnicity: People with African, Asian or Latin American ancestry are at higher risks of developing heart disease than other racial groups.

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The risk factors that are within your control and can be modified include:

• High blood pressure

• Cholesterol: High cholesterol, specifically or low density lipoprotein (LDL) and triglycerides and low 'good cholesterol" or high density lipoprotein increases heart disease risk.

• Physical inactivity and obesity: An independent risk factor and also predisposes to other risk factors of diabetes, high cholesterol and high blood pressure.

• Diabetes: Increasingly common in Canada and is a major risk factor that doubles the risk of heart disease compared to those who do not have diabetes.

• Smoking: Tobacco (chewing or smoking) increases heart disease risk as does second hand smoke exposure. There is a higher risk the earlier you start smoking but quitting smoking, no matter how long you have smoked will decrease your risk significantly.

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• Stress/depression: Chronic stress, social isolation, anxiety and depression increase the risk of heart disease and stroke.

While it can cause concern to know that you have a family history of heart disease, having this increased awareness can motivate you to be aware of the risk factors you can control. The good news is that it is never too late or too early in your life to start making positive changes to prevent heart disease.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. 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.

Read more Q&As from Dr. Wijayasinghe.

Click here to see Q&As from all of our health experts.

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.

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