You’re born with tens of thousands of genes you inherit from your parents. Most of them are doing great things for you, but in a few cases, the genes you’re born with may predispose you to some negative health consequences, including heart disease. Here, we look at the genetic risk factors for heart disease, how family history contributes to your risk, and what you can do to reduce your chances of developing heart disease.

Table of Content

  1. How do your genes influence your risk for heart disease?
  2. How much of your heart disease risk is genetic?
  3. What’s the difference between genetic factors and family history?
  4. How does your doctor assess your risk for heart disease?
  5. Can you prevent heart disease even if you have a family history of it?

How do your genes influence your risk for heart disease?

The genes that are passed down from your parents affect traits like the color of your hair and eyes, your height, and whether you’ll go bald. These are known as inherited traits, and they can also affect your risk for developing certain diseases and conditions. Genetic factors may have an indirect or direct influence on whether you develop heart disease. 

The indirect influence of genes on heart disease risk

If you’re genetically predisposed to high blood pressure or high cholesterol, your risk for heart disease is elevated, because high blood pressure and high cholesterol are important risk factors for heart disease. Likewise, if you have a genetic risk factor for drug or alcohol addiction, your risk for heart disease will increase if you become addicted. 

But the genes that influence your chances of developing heart disease aren’t necessarily related to the biological functions of your body. Genes also influence your personality. If you have certain genes that give you a taste for risk-taking, you may be more likely to engage in risky behaviors like smoking cigarettes or using drugs, both of which increase your heart disease risk. Conversely, these same genes may influence your proclivity for extreme sports that require a high level of physical fitness, thereby reducing your risk for heart disease. 

The direct influence of genes on heart disease risk

The genes you inherit from your parents may directly increase your risk for specific heart diseases. For example, familial hypertrophic cardiomyopathy is a heart disease usually caused by a gene mutation that leads to the thickening of the heart muscle. If one of your parents has or had this disease, you have a 50 percent chance of having it, too. 

Additionally, researchers have uncovered numerous underlying genetic risk factors for atherosclerosis, or the narrowing of the arteries. One of these is low-density lipoprotein receptor or LDLR, located on chromosome 19. People with this gene have high levels of LDL (“bad”) cholesterol and are predisposed to developing atherosclerosis, which can lead to a heart attack at an early age.

Positive genetic factors 

Humans have nearly 25,000 genes. Even if you are born with a gene—or a few genes—that raise your risk for certain heart diseases, you may also have others that offset this risk.

For instance, certain rare gene mutations have been shown to lower LDL cholesterol and triglycerides that contribute to heart disease. Although having beneficial mutations in your family isn’t a bulletproof vest against heart disease, it’s nice to know you may have a head start in protecting your heart health. 

How much of your heart disease risk is genetic?

So, how much of your heart disease risk is genetic, and how much is biological or environmental? Well, it varies, because it all depends on the specific disease and the unique genetic, biological, sociocultural and individual risk factors that contribute to it. But in general, the prevalence of heart disease directly caused by genetic mutations is very low. 

Even if you don’t have specific genetic mutations associated with inherited heart diseases, you may still have genetic, biological, environmental, or sociocultural risk factors that increase your chances of developing heart disease. This helps explain racial and ethnic disparities in levels of disease risk. 

For example, Black Americans are twice as likely as white Americans to develop high blood pressure by the age of 55—and high blood pressure is a major risk factor for heart disease. And while people of South Asian descent account for 25 percent of the world’s population, they account for 60 percent of heart disease patients. They also develop heart disease up to 10 years earlier than the general population—25 percent of heart attacks among South Asians occur before the age of 40, and 50 percent occur before the age of 50. The prevalence of heart disease is lower for Hispanic people (8.3%) than it is for non-Hispanic Whites (11.1%) and non-Hispanic Blacks (10.3%).

What’s the difference between genetic factors and family history?

The genes you inherit that can indirectly increase your risk of heart disease may not lead to heart disease at all. Depending on many other factors, you may never experience any health consequences from these genes—and you may never even know you’re carrying them.

Family history of heart disease is a factor that may increase your risk, but, like many genetic risk factors, it’s one of many influences—not a sure-fire sentence to heart disease down the road. Family history and genetic influences can combine to increase or decrease your heart disease risk, and these relationships are complex.

One scenario is having a parent who smoked cigarettes and died of heart disease. Research shows that children of smokers often pick up the habit themselves and become dependent, increasing their own risk of heart disease. Similarly, a child who grows up in a family that consumes an unhealthy diet bereft of fresh fruits and vegetables is likely to continue consuming a poor diet as an adult. The chances are good that one or more close family members has or had high cholesterol, diabetes, or high blood pressure, which contribute to heart disease and the child may also develop these conditions.

Another scenario using the same example is that a child may have become an adult who chooses an entirely different lifestyle specifically because they see the harm done by cigarettes or unhealthy food. In this case, the chances are good that the child won’t develop heart disease even though several family members did.

Sifting through family history can reveal risk factors like chronic stress, depression, and other conditions that may be the result of genetic or environmental factors—or a combination of them. For this reason, it’s not always clear based on family history alone that a genetic risk factor or a genetic disease has been passed on to you. But if heart diseases or risk factors for them are common in your family—especially among your parents and siblings—understanding how your environmental, sociocultural, and other risk factors may influence your own, individual risk helps you and your physician develop a prevention plan that addresses a wide range of factors.

How does your doctor assess your risk for heart disease?

To assess your overall risk for heart disease, your doctor will screen based on your family history. If your mother had a heart attack before the age of 55 or your father had one before the age of 45, your risk of having a heart attack is increased. Likewise, if an immediate family member needed a surgical intervention like a stent or heart bypass at a young age (under 55 for men, under 65 for women), you’re considered higher-risk for developing coronary artery disease. 

If you have family members with diabetes, high blood pressure, or high cholesterol, your risk for cardiovascular disease may be elevated. If your doctor feels genetic tests are in order, they’ll provide you with the information you need to decide whether genetic testing is right for you.

Can you prevent heart disease even if you have a family history of it?

In some cases, nothing you do will prevent you from developing a heart disease driven by genetics—you’re born with a set of genes, and they’re with you, in every cell, for life—and that might mean medical treatment for heart disease is inevitable.

But in most cases, what you’ve really inherited is a set of weighted dice. Your chances of developing a genetic heart disease may be lower if you take actionable steps to mitigate your risk. Engage in healthy lifestyle habits that keep your heart—and the rest of you—as healthy as possible, including eating healthy food, exercising to strengthen your heart, and monitoring your heart health if you’re at risk. This will go a long way toward preventing heart disease—or successfully managing your disease if you do develop one.

Take charge of your heart disease risk with Forward

Forward’s healthy heart program can help you lower your chances of a heart attack, stroke, and heart disease whether or not you have a genetic risk. This doctor-led program includes comprehensive blood testing and risk assessments, along with weight and blood pressure monitoring and personalized exercise and diet optimization. Ongoing support and biometric monitoring helps you stay motivated to reach your long-term heart health goals so you can live long and prosper—regardless of what your genes say. 

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