Expert explains how to improve heart health, even if your family has history of heart conditions

ROCHESTER, Minn. — It’s not unusual to have one or more family members with some form of heart disease. Nonetheless, some people may not even know they have heart disease until they experience a heart attack or stroke or are diagnosed with heart failure. Despite the prevalence of heart disease, many people are still unclear about how genetics can impact heart disease and, most importantly, what they can do to lower their risk. Stephen Kopecky, M.D., a cardiologist at Mayo Clinic, explains how you can improve your heart health, even if your family has a history of cardiovascular problems.

Heart disease is a broad term that describes several conditions impacting the heart’s structure and function. The most common type of heart disease is coronary artery disease — typically caused by plaque buildup in and around the artery walls on the heart — but you also may have heard of heart valve disease, heart muscle disease (cardiomyopathy), conditions involving the heart’s electrical system (arrhythmias), or congenital heart disease. The exact symptoms depend on the type and severity of the disease.

Lifestyle factors — encompassing how much you move, what you eat, how well you sleep and more— play the biggest role in your heart health, Dr. Kopecky says. But circumstances you can’t control — namely, your genetics and family history — also impact your risk of heart disease.

Congenital heart disease, for example, is thought to run in families — meaning the condition may be passed down, also called inherited, from parent to child. Other research indicates that some genetic conditions, such as Down syndrome and certain types of muscular dystrophy, may be linked to cardiovascular conditions.

Family history may have a hand in heart disease that develops later in life as well. Though the exact numbers range, research consistently indicates that people with a family history of coronary artery disease, for example, have a significantly higher risk of developing the condition themselves. Similarly, people from families with two or more premature heart-related deaths have a three times higher risk of developing cardiovascular disease themselves before age 50.

Understanding your family history is an important piece of the puzzle, according to Dr. Kopecky. But it’s equally important not to blow genetic risk out of proportion. Genetics account for 20% to 30% of your risk, Dr. Kopecky says. But positive habits such as regular exercise and a healthy diet can impact your genes much more drastically.

“Certain good lifestyles can ‘turn off’ the bad genes and ‘turn on’ the good genes,” Dr. Kopecky explains. “We see patients in our prevention clinic with very high cholesterol, genetically determined. We know that if they have a good lifestyle, starting early in life, it lowers their heart attack and stroke risk.” In other words, Dr. Kopecky says the day-to-day, year-over-year habits you make to protect your heart health are oftentimes much more impactful than the genetic lottery.

There’s no magic or any one routine that will prevent heart disease and its more serious complications such as heart attack and stroke. By now, most people know it’s the small, consistent choices in all parts of life that add up in big ways.

“If you have genetic risk factors, it’s more important to have a healthy lifestyle,” Dr. Kopecky says. “I tell patients frequently: You have a new part-time job called ‘your health’.”

To get started, consider the following strategies:

• Incorporate a variety of nutritious foods. When making choices for meals and snacks, emphasize fresh fruits, vegetables, legumes and whole grains. Limit overly sugary, salty and processed foods that can raise blood pressure and cholesterol.
• Move as much as you can. For adults, the Centers for Disease Control and Prevention (CDC) recommends a minimum of 150 minutes of moderate activity every week. Exercise can help lower blood pressure, decrease cholesterol levels and maintain a heart-healthy weight. To get started, Dr. Kopecky recommends incorporating as much movement into your day as possible — and making time for light strength training and interval workouts as often as you can. Gardening, walking and taking the stairs all count!
• Prioritize sleep. Dr. Kopecky says getting enough quality sleep is critical for your heart health and overall quality of life. To ensure you’re well rested, Dr. Kopecky recommends consistently going to bed and waking up at the same time. “Don’t set an alarm to wake up. Set an alarm to go to sleep or get ready to go to bed,” he adds. “You shouldn’t need an alarm to wake up unless you’re traveling. Just wake up on your own.”
• Quit smoking and avoid alcohol. Heart attacks are more common in people who smoke. If you use any tobacco products, quitting as soon as possible helps lower your risk of heart disease. Similarly, it’s a good idea to limit your alcohol intake or avoid alcohol altogether.
• Lean on your healthcare team. If you have a family history of heart attack or heart disease — especially in first-degree relatives such as parents or siblings — or are unsure of your risk, talk with your healthcare team. Your care team also can help you determine the best plan for protecting your heart health.

Though it can seem overwhelming to make so many changes, just remember: Dr. Kopecky says nothing you do is ever too little or too late. When it comes to your heart health, you may find that positive reinforcement is a much more powerful motivator than shame or fear. Even small changes can compound and help protect your heart health, so do what you can as often as you can and celebrate the successes along the way.

For more information about heart health, please visit Mayo Clinic Press and MayoClinic.org.

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Media contact: 

• Sharon Theimer, Mayo Clinic Communications, [email protected]