Family history and heart disease (patient information)

Editor-in-Chief: Alexandra M. Palmer

Overview
Whereas you can control other risk factors for heart disease such as smoking and physical inactivity, you can’t alter your family history. For this reason, it is highly important to be aware of your family history and modify your lifestyle to eliminate other risk factors you may have, such as smoking, diabetes, and physical inactivity.

What is Family History?
In medicine, a family history consists of information about disorders that a patient's direct blood relatives have suffered from. Genealogy typically includes very little of the medical history of the family, but the medical history could be considered a specific subset of the total history of a family.

How do I obtain my family history?
The best and most accurate way to acquire knowledge about your family history is to ask your living family members.

Gather information about:


 * Family members with known heart or vascular disease. This should include myocardial infarction (heart attack, coronary thrombosis), heart failure (congestion, dropsy), aneurysm (bubble, blowout of artery), stroke (CVA, hardening of arteries), sudden death, arrhythmia (rhythm disturbance, WPW, irregular or racing heart), and rheumatic fever.


 * Familial risk factors for cardiovascular disease. These include hypertension (high blood pressure, high blood), diabetes mellitus (high sugar), and hyperlipidemia (high fat, high cholesterol).


 * Congenital heart disease or a genetic syndrome in the family. The questions should focus on birth defects, a blue baby, unusual stature, and mental or physical retardation. The possibility of maternal rubella, drugs, alcohol, and viral infections during pregnancy should be questioned.


 * The name, age, sex, location, state of health, and occurrence of congenital defects or significant illnesses.


 * The race, religious, and ethnic background and the occurrence of abortions, stillbirths, miscarriages, and early death.

List all family members, living and dead, beginning with the oldest child and proceeding through each of the children, brothers, sisters, parents, uncles, aunts, and grandparents. Parental consanguinity (parents who are blood relatives) should be elicited, since this will significantly increase the possibility of a rare, recessively inherited disease.

How precise are family histories?
Family histories may be imprecise because of various possible reasons:
 * Adoption or illegitimacy
 * Lack of contact between close relatives
 * Uncertainty about the relative's exact diagnosis

In complex situations, a family tree may be necessary to cover the necessary aspects.

How will a doctor use my family history to benefit my health?
Although often neglected, many doctors glean information on family morbidity of particular diseases (e.g. cardiovascular diseases, autoimmune disorders, mental disorders, diabetes, cancer) to appreciate whether a person is at risk for developing similar problems. Use of a genogram can be helpful in a family history, which is in the format of a family tree.

I have no symptoms of heart disease, but heart disease runs in my family. Should I be seeing a doctor about this?
If you have a family history of heart disease, it is important your doctor is aware of this. In diseases with a known hereditary component, many healthy people are now tested early to prevent the symptoms from developing.

How can I reduce my risk of heart disease when it is in my genes?
Although it is not possible to alter your family history, you can control your lifestyle.

Smoking, physical inactivity, high blood cholesterol, obesity and overweight, and diabetes mellitus all contribute to heart disease. If you can eliminate these factors through means such as exercise and minimizing fat intake, you can reduce your risk of heart disease.