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Outsmarting Your Family History

By Deborah Pike Olsen

If your family tree is full of broken hearts, you may worry that there’s a space for you on the next rickety branch. After all, one to five percent of people younger than 65 who have a heart attack are more likely to have inherited a susceptibility to heart disease. In fact, researchers believe at least two dozen gene regions are involved in cardiovascular disease, says Sekar Kathiresan, M.D., author of several recent studies on the genetics of heart disease and director of the Cardiovascular Disease Prevention Center at Massachusetts General Hospital in Boston. At least 13 of those regions predispose you to high levels of “bad” LDL cholesterol, which is proven to cause heart disease. The goal is to identify people at high risk for developing heart disease and treat them early with lifestyle changes and, often, medications that target these genes.

In the meantime, it pays to figure out your risk for having a heart attack, because you can use that information to protect yourself. Dr. Kathiresan recommends using the Framingham Risk Score, which calculates your chance of developing heart disease in the next 10 years. The test uses your age, gender, total cholesterol level, “good” HDL cholesterol level, blood pressure and whether you smoke to determine your score. If your score is less than 5 percent you’re considered low risk; if it’s 5 to 20 percent you have an intermediate risk; and if it’s more than 20 percent you have a high risk.

Regardless of your risk level, there are simple ways to reduce your chances of having a heart attack. “Your lifestyle is key regardless of whether you have a genetic susceptibility to heart disease,” says Dr. Kathiresan.

  • Get regular exercise—even if it’s just going for a walk—at least 30 minutes a day, five days per week.
  • Maintain a healthy weight. Your body mass index should be 25 or less. Use this calculator to determine whether you’re in the ballpark: http://www.nhlbisupport.com/bmi.
  • Eat foods low in saturated fat (less than 30 percent of total calories).
  • Don’t smoke.

There are a number of medications that have been shown to reduce your risk of a heart attack: these include cholesterol-lowering drugs called statins; aspirin; and blood pressure-lowering drugs, says Dr. Kathiresan. Although many of these medications have only been studied in older adults (women over 60 and men over 50), they may be beneficial if you’re younger and have a strong family history of heart disease. If you’re at particularly high risk, talk to your doctor about which, if any, may be beneficial for you.

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