Family History of Heart Disease




First we need to clarify some definitions. When referring to “heart disease,” typically that implies coronary artery disease which is the most common type of heart or cardiovascular disease in America. Interestingly, other types of heart disease such as congestive heart failure (including cardiomyopathy), heart valve disease, or atrial fibrillation are not typically included although more and more evidence is suggesting some degree of genetic predisposition to each of these types of heart problems.

And when referring to “family history,” the traditional definition, based on epidemiological data (that is evidence based on verified population studies), is if a first-degree male relative (e.g. father, brother) has suffered a heart attack before the age of 55, or if a first-degree female relative has suffered one before the age of 65, you are at greater risk of developing heart (coronary) disease.

It should be noted that most of this data was collected when most Americans were not living past their early seventies, and currently many will live well into their eighties. Thus the data is less clear about lifelong risk of developing heart disease if one’s relatives had a heart attack in their sixties or seventies. However, most cardiologists do feel that the family history risk factor is a spectrum of risk and all details of the family history should be considered as potentially important.

However, you can protect yourself by taking care of your heart, as the development of cardiovascular disease involves many different factors, not just your family history. 
Whereas family history indicates a genetic predisposition to heart attack, it also means that you may be genetically vulnerable to developing other contributing risk factors, like a genetic cholesterol abnormality, obesity, diabetes, high blood pressure — all of which can create a predisposition to or an increased risk of heart disease.




Family history clearly is a risk factor that is part of a spectrum of risk rather than being a black-and-white situation. A parent with an early-age heart attack should be a red flag for someone or their siblings. For instance, if both of your parents have suffered from heart disease before the age of 55, your risk of developing heart disease can rise to 50% compared to the general population.

The general gist is that the more family members you have or had with arterial disease (blood vessel problems), the closer they are related to you, and the younger the age when they had their problems, the magnitude of risk to you of having premature heart disease increases.

However, you can protect yourself by taking care of your heart, as the development of cardiovascular disease involves many different factors, not just your family history. 
Whereas family history indicates a genetic predisposition to heart attack, it also means that you may be genetically vulnerable to developing other contributing risk factors, like a genetic cholesterol abnormality, obesity, diabetes, high blood pressure — all of which can create a predisposition to or an increased risk of heart disease.




Unfortunately, cracking the genetic code has not yet yielded useful means to better assess risk for the most common types of cardiovascular disease in an individual. Thus genetic analysis, while potentially useful for rare types of cardiomyopathies or arrhythmias that can cause sudden death at an early age, is still not indicated for better assessing the risk of having coronary artery disease or a heart attack. Chances are that even once we are able to locate a gene that makes you susceptible to premature heart disease, we will also find that lifestyle can modify that gene’s effect.

When a heart attack occurs in a relatively young family member, it’s important that all first-degree relatives are screened.

If you do have a strong family history [of heart attacks], particularly at a young age, it’s in your best interest to make sure your blood pressure is under control and get your cholesterol checked. One should do those things we know can lower your risk in helping to prevent having a heart attack.

Newer technology also now allows us to image the arteries of the heart (coronary calcium scans) or neck (carotid IMT imaging) to help determine how aggressive we need to be with recognizing and treating risk factors for heart disease and stroke.

For more information about Family History of Heart Disease, click here (CardioSmart) or here(American Heart Association).

Written by and/or reviewed by Mark K. Urman, M.D. and Jeffrey F. Caren, M.D.

Updated 11/29/13


PLEASE NOTE: The information above is provided for general informational and educational purposes only and should not be used during any medical emergency. The information provided herein is not intended to be a substitute for medical advice, nor should it be used for the diagnosis or treatment of any medical condition. Accordingly, it should not be relied upon as a substitute for consultation with licensed and qualified health professionals who are familiar with your individual medical needs. Call 911 for all medical emergencies. Links to other sites are provided for information only – they do not constitute endorsements of those other sites. Please see Terms of Use for more information.

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