Kids with family heart risk should adopt healthy habits
Q: I had a heart attack in my 50s, and so did my dad. Heart disease obviously runs in the family. How do I talk to my kids about what this means for them?
A: As a parent, you already know that taking care of your children is just as (if not more) important as taking care of yourself. If you have a family history of heart disease, that means teaching your children what they can and should do to prevent heart disease.
Family history contributes to heart risk in two ways. The first is directly, through genes passed from one generation to the next. Genes affect many factors that influence heart disease risk - for example, the level of LDL "bad" cholesterol in your blood, your blood pressure, how easily your blood vessels relax, how easily your blood clots, whether you have pre-diabetes or diabetes, the level of inflammation in your body, and many more.
Genes, however, are not the whole story. Families often share the same diet, have the same attitude toward physical activity, live in the same area and belong to the same culture. If your parents smoke, you're more likely to smoke. All these factors may also explain why heart disease and stroke run in some families.
In other words, genes are not destiny.
I have a friend whose father died in his early 50s of a heart attack. That "gave him religion." Beginning in his early 30s, he began to eat a healthy diet and became an avid runner. He ran every day - by which I mean every single day, in rain, sleet, hail or snow, for 30 years.
He's alive and power-walking, now in his 70s. While I can't prove it, I think his commitment to a healthy lifestyle overcame his genetic risk.
At the same time, while genes are not destiny, they greatly affect your risk. That's why I would tell your kids that for them, adopting a healthy lifestyle is really important.
Heart disease runs in my family, and the way my late father put it to me was: "If you're really tall, you have to worry every time you walk through a door. If you're not really tall, you don't."
It's never too early to start the discussion. If your kids haven't yet reached young adulthood, it's more important to reassure them than to scare them. Say, "We have heart disease in our family," and explain what that is. And tell them that a healthy lifestyle is proven to reduce the risk.
There are different kinds of heart disease, but I'm assuming the kind that runs in your family is the most common: atherosclerosis. If so, ask your pediatrician if certain tests should be performed on your kids - like blood cholesterol levels, or regular blood pressure testing - that might not be necessary in other kids.
So, the message to your kids is simple: Their genes do not doom them to heart disease, but those genes do make adopting a healthy lifestyle very important.
• Dr. Anthony Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.