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Understanding the Connection: Genetics and Heart Health

If you take a look at any family, you can probably spot traits that family members share. Maybe they stand out as taller than just about anyone else at group events. Or you notice that a lot of them have free-hanging (or unattached) earlobes. Perhaps a family photo shows that just about everyone has dimples. There are also genetic traits that run in families that you can’t see. They can include risk factors for heart disease. Heart disease includes coronary artery disease, heart failure, arrhythmias and other heart problems, and it can affect people and families from all races and ethnic backgrounds. Maybe you have been struggling with very high cholesterol for a long time despite taking your medications, or maybe your mom or dad had a heart attack when they were young. When you know more about your risk, you can work with your health care provider to make smart decisions about your health. We connected with Esteban Astiazaran Symonds, MD, a medical geneticist with Banner – University Medicine, to find out more about the link between heart disease and family history. What are genetics? Genetics is the study of traits that are passed down through generations in your family. Your genes are part of your DNA, which is the code that makes you unique. Your genes determine things like your eye color and your height, and they also play a role in your overall health. Your genes can make you more or less likely to have certain health conditions, influence your metabolism and play a role in how your body responds to things like diet and exercise. While your genes are a factor in your health, they aren't the only thing that matters. Your lifestyle, environment, life experiences and more also make a difference. The role your genes play in heart disease Your genes can make you more or less likely to have risk factors for heart disease like high cholesterol, cardiomyopathies, atherosclerosis, irregular heart rhythms and other conditions. “Many different types of heart disease are influenced by our genes and can run in families,” Dr. Symonds said. “The most common heart diseases, like coronary artery disease and high cholesterol, are influenced by many different genes as well as environmental factors, such as diet, exercise and tobacco use.” Other types of heart disease can be caused by just one genetic change that has a strong effect. “These include rare conditions that mostly affect the heart's muscle (such as hypertrophic cardiomyopathy) or the heart rhythm (such as long QT syndrome),” Dr. Symonds said. Another example is a condition called familial hypercholesterolemia, which causes very high cholesterol levels and may lead to heart disease before age 50. If you know or suspect that you have certain heart problems or that they run in your family, talk to your health care provider. They can recommend the right screenings, lifestyle changes and treatments and take your family history into account when they are planning your care. Why it’s important to understand your family history Knowing the illnesses and conditions that your family members have can help you assess your own risk. This information can help you manage your risk factors and make lifestyle choices that may help keep your heart healthy. Be sure to share your family history with your provider. “Providing a complete family history gives your providers a better picture of your genetic risk. They will use this information in addition to your personal history, such as age, sex, race, cholesterol, blood pressure, etc., to determine your overall risk of heart disease,” Dr. Symonds said. In some cases, your provider may suggest genetic testing to evaluate your risk for heart disease. Genetic testing looks for specific genes that can run in families to see if you might be at higher risk for certain conditions. Your provider or cardiologist may recommend genetic testing if they suspect you have a heart problem that’s caused by a change to a single gene, or you have a relative who has a genetic disease. “Some clear indications for genetic testing include a personal or family history of sudden cardiac arrest, heart muscle disease, very elevated cholesterol, some types of arrhythmias and aneurysms, which are balloon-like bulges in the aorta or brain arteries,” Dr. Symonds said. If you’re concerned about your genetic risk factors, you can schedule an appointment with a genetic counseling clinic so you can better understand your risk and your possible need for genetic counseling. Many of these conditions occur as you age. “Providers will usually suspect a genetic cause when these symptoms occur at an earlier age than expected, when there is a significant family history or when other more common causes have been ruled out,” he said. By talking to a genetic counselor, you can better understand the emotions you might feel and decisions you might face if you have genetic testing. A counselor can explain the pros and cons of genetic testing and the effect the results might have on you and your family. Taking control of your heart health The goal of genetic testing is not just to identify risk, but to help you find ways to keep your heart as healthy as possible. Whatever your genetic risk is, the choices you make can shape the health of your heart. Keep the lines of communication open between you and your health care provider. Ask them any questions you have, so you can best understand your heart health and what you can do to improve it. Educate yourself about any heart conditions and risk factors. You and your health care provider can work together to create a heart health plan that takes into account your genetic risks and lifestyle choices. If you need to make changes, you can work together to set realistic goals. Be sure to see your health care provider for regular check-ups. That way, you’re more likely to spot any issues early, when they can be treated more easily. You can stay on top of any screening tests you need and make sure your lifestyle changes and treatment plan are working well. You can work together to make decisions about your treatments. And you’ll feel confident that you’re doing everything you can to keep your heart healthy. You may also want to connect with others in addition to your provider. Things like joining a fitness class, taking stress management classes or talking with friends and family can help you find the support you need. Joining a support group for people who have the same genetic risk factors may also be helpful. Sharing your experiences and talking to others on a path like yours can help you feel empowered and reassured. Lifestyle changes can reduce your risk Keep in mind that diet, exercise and stress management can help lower your risk of heart problems whether you have a family history of them or not. “Genetics is only one of several risk factors that influence the most common heart diseases. Eating a healthy diet, watching your weight, staying physically active, living tobacco-free and managing any other health conditions will have a huge positive impact in reducing your overall risk for the most common heart diseases,” Dr. Symonds said. A heart-healthy diet is important for everyone, and it can make a big difference for people who have a family history of high cholesterol. Getting regular exercise like walking, biking or aerobic workout classes can help counteract any negative genetics linked with heart health. Stress management techniques, such as mindfulness, meditation or yoga can help counteract the effects of stress on the heart. The bottom line Your family history, or genetics, can influence your risk for some heart conditions and risk factors. By knowing your family history and sharing it with your health care provider, you can create a care plan that could include lifestyle changes, genetic testing, screenings or treatments. You and your provider or a Banner Health expert can work together to gather the information you need and make decisions about your care. Take our free Heart Age Test to learn more about your risk for heart disease.