If you’re worried about having a heart attack because you have a family history of heart disease or of other cardiovascular problems, knowledge is power. The more you know about heart attacks and heredity, the more power you’ll have to take your health into your own hands. Here’s what you need to know.

1. Heart Disease Is Sometimes an Inherited Condition

Some heart diseases can be caused by genes passed down from a parent. Of these, only some increase a person’s chances of having a heart attack.

Familial Hypercholesterolemia

Familial hypercholesterolemia is an inherited disease where a person’s body doesn’t properly eliminate one type of cholesterol, low-density lipoprotein (LDL). This can cause your cholesterol levels to be very high, resulting in “fatty bumps” called atherosclerotic plaques building up in your arteries. This includes your coronary arteries, which supply blood to the heart muscle. This buildup can cause a heart attack, resulting from the heart not getting enough blood or oxygen via the blocked artery. Familial hypercholesterolemia can be identified through genetic testing.

If you think that you or a loved one is experiencing a heart attack, you should call 911 immediately. Signs of a heart attack include:

• Chest discomfort, usually in the center of the chest
• Discomfort in other parts of the upper body, including the arms, back, neck, jaw, or stomach
• Shortness of breath
• Cold sweat
• Nausea
• Lightheadedness

Doctors treat heart attacks by getting into the blocked artery with a small wire, opening it by crushing the clot with a small balloon attached to the wire, and placing a small metal armature (called a stent) that keeps the artery open. Immediate treatment is essential to prevent losing the affected part of the heart muscle forever.

It’s important to detect the condition early to get treatment before that happens.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is a heart disease that is, in some cases, hereditary. It occurs when all or part of the muscle that makes up the heart wall becomes thicker than normal. Hypertrophic cardiomyopathy is unlikely to lead to a heart attack (coronary arteries may not have atherosclerotic plaques), but it can cause a sudden cardiac arrest or heart failure. (Heart failure occurs when the heart muscle isn’t strong enough to pump blood as well as it should.)

These events don’t happen because of blockages in the arteries, but because of changes in how the heart is functioning: In some people with hypertrophic cardiomyopathy, their heart muscle is ill-structured and can develop unwanted electricity that can suddenly stop the heart. The heart muscle can also be weak and cause heart failure.

Dilated Cardiomyopathy

A second hereditary heart disease is dilated cardiomyopathy. This is the opposite of hypertrophic cardiomyopathy in that the heart muscle becomes thinner and, therefore, weaker, leading to heart failure. It can also occasionally lead to a sudden cardiac arrest, but this isn’t the same as a heart attack, where arteries become blocked. Rather, it’s also caused by excess electricity in an ill-structured heart muscle. Only about one-third of people diagnosed with dilated cardiomyopathy have it for genetic reasons.

2. Researchers Know of at Least 50 Genetic Markers for Heart Disease Risk

The human genome — the entire set of DNA instructions found in a cell — is huge, and studying it takes time. However, one recent study looked at 50 genetic markers that can raise heart disease risk. One researcher predicted that, within the next few years, there will be more than 200 of these.

Note that having these markers does not automatically mean that a person develops heart disease. Instead, researchers know that hereditary heart disease involves several factors — and likely multiple genes.

Research is ongoing with the hope of soon having a better understanding of how all of these factors are connected. There’s already genetic screening for some heart diseases, like hypertrophic cardiomyopathy.

3. Genetics Are Only One Risk Factor for Heart Attack

A number of factors can raise a person’s chance of having a heart attack, and genetics is only one of those. Other important factors include:

• Blood glucose (sugar) levels/diabetes status
• A history of smoking or exposure to secondhand smoke over a long period of time
• Age
• Low levels of physical activity
• High cholesterol
• High triglycerides
• Obesity
• Stress
• Diet
• Illegal drug use
• Some autoimmune diseases
• Metabolic syndrome

Some factors that contribute to heart attack risk are under your control and some of them aren’t. You and your primary care provider or cardiologist can weigh all of these factors when discussing if you’re at higher risk of having a heart attack.

4. Environment Is Important

Families also tend to pass on aspects of what are called “shared environments” to the next generation.This can include exercise habits, eating habits, tobacco use, and more. These factors could increase the next generation’s chances of experiencing a heart attack.

Identifying someone’s risk for a heart attack can be challenging because, while a doctor may be able to test for genetic risks, they can measure for factors like shared environment. You and your health care professional may need to talk about your lifestyle when looking at your heart health.

5. Lifestyle Matters a Lot

If you’re concerned about having a heart attack, you should take a look at your daily habits. Making changes to what you eat, how much you eat, how often you exercise, and other lifestyle factors can make a huge difference in health outcomes that involve your heart.

In the study mentioned above, researchers looked at people who had one or more of the 50 known genetic markers for heart disease. They compared this group of people to those who didn’t have any of the markers. Then, they looked at people in these groups who had healthy lifestyle markers, which included:

• Not being obese
• Eating a heart-healthy diet
• Not currently smoking
• Regularly engaging in physical activity

Although the researchers found that people with genetic markers did, in fact, have a higher chance of having a stroke or a heart attack, they also found that the healthy lifestyle markers reduced that chance. People with genetic markers for heart disease who embraced three out of the four lifestyle markers lowered their heart attack risk by 46 percent. People without the genetic risk also experienced a similar, lower risk of having a heart attack when they adhered to the lifestyle factors.

This indicates that lifestyle changes have a major impact on heart attack risk. Your genes are not a guarantee that you’ll have a heart attack.

6. Your Doctor Can Help

If you’re concerned about having a heart attack because other family members have had one, talk to your doctor. Your cardiology team can help you evaluate your lifestyle so you can have a better idea of whether you’re at a greater risk of experiencing one. They can also help you look at any existing heart conditions to determine whether they raise your risk, too.

Once you have a good idea about your level of increased risk, your health care provider can help you identify lifestyle factors and devise a plan to embrace them. If you need outside professional help, like from a physical therapist, a dietitian, or an exercise specialist, your doctor can refer to you someone they know and trust.

It’s never too late to lower your risk of having a heart attack. Whether your high risk comes because of genetics, lifestyle factors, or both, you can start making choices today that could make you healthier tomorrow.

Talk With Others Who Understand

On MyHeartDiseaseTeam, the social network for people with heart disease and their loved ones, more than 61,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

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