Can you inherit a bad heart?

Now with the GMA Health Alert on heart disease, about 30% of people have a family history of heart disease. But can you outrun your genetics when it comes to your risk of heart attack or stroke? Our chief medical correspondent and practicing cardiologist, Dr. Tara Narula, joins us now. Doctor, so glad to have you here on this topic. My grandfather was a cardiologist, also had a history of heart disease. He had two heart attacks and sextuple bypass surgery. He was a do as I say, not as I do kind of guy. If someone has a family history of heart disease, as I do, as many people do, what conversations should they be having with their doctor and then maybe a cardiologist after that? Well, the first thing is to just have conversations with your family. So often I see patients, and in my history taking, I always ask about family history and many of them will say, I don't know. So you really want to pick up the phone, I say, and call. Ask your parents, your siblings, aunts and uncles, what kind of cardiac problem did they have? When did it happen? When did they die from said cardiac problem? And maybe keep this written down somewhere. So when you go to the doctor's office and they ask you, you can tell them. That's going to be really helpful information. Typically when we say someone has a genetic predisposition to cardiovascular disease, it's if they had a female mom or sister who had an event before the age of 65 or a male father or brother who had a cardiovascular event before the age of 55. Those are technically the things that count as a possible genetic predisposition. Not that we forget about the aunts and uncles and grandparents. We pay attention to that too. But that's really what we're looking at, those first degree, what we call relatives. And things that can be genetic, well, I mean, we're talking about hypertensive disorders, cholesterol disorders, some types of electrical disorders of the heart, some types of heart failure, heart attack, stroke. So there's a lot of conditions that can be passed on genetically. And how big of a difference can lifestyle changes actually make if your history already is pointing in that direction? So you can outrun your genes. But as I tell my patients, when you have a family history, it's almost like the deck is a little bit stacked against you. So you really want to make sure that all your risk factors are optimized. And that means things like your blood sugar, your body metabolics or weight, your cholesterol, your blood pressure. You want to really pay attention to that and get them as perfectly controlled as possible because you obviously can't fight the genes or your age. That's really the only other thing that's a risk factor in general. And like you said earlier, a lot of people may not know their family history. So if you don't know that history, how do you go about screening? So there are tests that we use in cardiology to screen. I would say one of the big ones is a risk calculator. You can actually go online yourself and look it up. It's called Prevent. And essentially, you can plug in your age, your gender, whether you have high blood pressure or smoke, and it will give you a 10-year risk score for you having a cardiovascular event or a 30-year risk score. In addition, we have a calcium score, which I love to use. A very quick CAT scan of the heart, looking for spots of calcified plaque in the arteries that typically cost about $100. Very low radiation, about the same as a chest X-ray. And then the last is a lipoprotein, little a, LPA. It's a blood test, also genetic, and increases the risk of heart attack and stroke. And you can do that at any age, right? You can do these at any age. Good to know. Better to start early.