How Your Family’s Health History Can Help You Address Heart Issues – I’ve always known that my family has a history of heart-related health problems. My maternal grandmother had high blood pressure, as do other relatives on my mom’s side. Some also have heart rhythm issues.
I never thought to mention those details to my primary care physician until recently—which was a mistake. He made it clear he should have known about this from the start in order to have me screened for anything a basic check-up might miss, and he referred me to a cardiologist to get that underway.
The Centers for Disease Control and Prevention (CDC) notes that a history of cardiovascular conditions in your biological family—which includes biggies like high blood pressure, heart attacks, and heart failure, among others—raises your risk of heart disease. For instance: According to the Cleveland Clinic, having one or more close family members who were diagnosed with high blood pressure before age 60 doubles a person’s risk of developing hypertension (a.k.a. my exact situation).
Plus, as Marietta Ambrose, MD, MPH, director of Penn Cardiology International and an associate professor of clinical medicine at the University of Pennsylvania, tells SELF, “There may be times when the only way you have an idea that there is an issue is if you know your family history.” For example, a sudden lack of appetite might not seem super concerning—but if cardiovascular issues run in your family, it can be a potential indicator of something more serious, like heart failure, especially if you have other symptoms.
When certain heart problems are caught before they pose a more serious risk to your health, they can often be treated much more effectively—meaning you might also reduce your risk of developing complications down the road. Getting the full picture of your family members’ heart health is enormously useful to this process—and if you’re adopted or speaking to your biological family isn’t possible for whatever reason, you have options when it comes to understanding this too. Here’s how your birth family’s health history can help you get answers.
What should you know about your family’s heart health history?
At a minimum, do what you can to find out if anyone in your biological nuclear family—meaning, your parents and siblings by birth—had or has heart issues, Sanjiv Patel, MD, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, tells SELF. “It can also be helpful to have information from grandparents, aunts, and uncles,” he says, so if you also have that info or that’s all you can get, don’t discount it.
But what details should you look for, exactly? Having a general inkling that some family members had heart-related issues is a good place to start if it’s all you’ve got access to, but if you can get more specific, it’ll help you at your appointment. “It’s important to know exactly what heart condition [your family members] had or were diagnosed with, and the age that they [were diagnosed],” Jim Liu, MD, a cardiologist at The Ohio State University Wexner Medical Center, tells SELF. Conditions like coronary artery disease and risk factors like high blood pressure and high cholesterol are often influenced by a person’s genetics.1 Cardiomyopathies, sudden cardiac death,2 aortic aneurysms, and certain heart valve defects also sometimes signal underlying conditions that can be hereditary, Dr. Liu says. If someone in your family needed stents in their heart or bypass surgery or even died at a young age for unclear reasons, bring that up to your doctor.
If there’s a known heart issue in your family, but you’re unable to get in contact with that relative about when it was detected, estimating even a rough time frame of when they were first diagnosed—like, if you think it was sometime in their late 30s or early 40s—can help, Dr. Liu says: “If your relatives developed heart disease younger than 65, that would be more concerning for a genetic predisposition than if they had it at an older age.”
Dr. Ambrose advises that getting ahold of these facts can be “tricky” in some families, even when you’re in contact and have a generally good relationship with them. “Health is very personal,” she says. If you have a close family member who hasn’t volunteered their heart health history, try (gently) nudging for more details by making the conversation more about your health rather than theirs, saying something like, “My doctor has asked me questions about our family history of heart disease and I realized I didn’t know the details. Are you comfortable talking about your experience with me, even in broad strokes?” Whatever their answer is, be ready to respect that choice.
If you were adopted, your family’s medical and genetic history is sometimes included in a report that’s given to your adoptive parents—but that may depend on whether your adoption was open (your birth parents were potentially able to be in contact with you) or closed (it was arranged that you’d have no contact with them).3 Even if you do get access to a report that outlines some health info, what’s contained within it and when it was made will vary by state. (You can check out more information about that here. And for a more detailed sense of how this process can work, SELF previously reported on some ways to fill in the gaps, including perspectives from people who have also been in this situation.)
As for using genetic testing to shed light on potential heart issues, which might be something you’re considering if you’re adopted or otherwise out of touch with your birth family, Dr. Ambrose says it’s not for everyone. That’s because genetic testing has its limits; many tests are unable to tell with 100% accuracy if a person will develop symptoms of an inheritable condition or how those symptoms will progress, per the US National Library of Medicine, so they need to be interpreted by a doctor who can offer more context. However, if a doctor suspects you might have or develop a specific cardiovascular disease, they might recommend genetic testing to get a diagnosis, Dr. Ambrose adds.
How to use your family’s heart health history to make informed decisions about your well-being
If someone in your bio family has heart problems, don’t freak out: It doesn’t mean that you’ll automatically develop them too. Yes, that does increase your risk of developing an issue—but there are loads of other factors that might be meaningful, and this genetic link is just one part of a fuller picture.
Bring any information you turn up to a primary care physician first (if you’re not already seeing a specialist): Depending on what you share, your PCP might refer you to a cardiologist who can take a closer look at your overall health, as well as any symptoms that could be indicative of a larger cardiovascular issue.
If you do seem to be at risk of developing a form of heart disease, a cardiologist will usually perform a series of screenings and consider those along with any family history you’ve shared, Dr. Ambrose says. “Family history is sometimes more important than test results, but sometimes the test results are more important. We use this information together in most situations.”
When it’s not possible to access some or all of your family health history, tell your doctor that and ask how you can be proactive. “Family history does matter, but if you don’t have it, you can still aim for good heart health by seeing doctors regularly who can screen for diseases using evidence-based, recommended heart health assessments and factoring in for the ‘unknown’ family history,” Dr. Ambrose says.
In the event you have a condition or face a significant risk of developing one that has a link to your family’s health history, the next steps “depend on what the specific heart [issue] is,” Dr. Liu says. “For example, if someone has borderline [high] cholesterol levels but has a family history of premature coronary disease, that family history may push them to start on a cholesterol-lowering medication sooner.” He adds that certain cardiomyopathies (a group of heart muscle problems) in the family may mean you should be screened with an echocardiogram to monitor your heart. Again, a doctor can guide you from here.
When it comes to your family’s heart health history, and especially if you were adopted or don’t have a great relationship with your biological family, there are a lot of pieces to put together. If you don’t get all the answers at once, that’s totally fine—being proactive with the information you do have is a great step all on its own.
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