Does Heart Disease Run in Your Family? Here's What You Should Know

Is Heart Disease Genetic?

Heart disease is the leading cause of death in the U.S., both among people assigned male at birth and those assigned female at birth, responsible for more than 650,000 deaths per year, according to the Centers for Disease Control and Prevention (CDC). (The most common type of heart disease in the U.S. is coronary artery disease, which can lead to a heart attack.)

For decades, experts have known that coronary artery disease can run in the family — and since the mid-2000s, researchers have identified certain gene variations that can increase the risk of the condition.

One oft-cited study in The New England Journal of Medicine from December 2016 found that people who were the most genetically predisposed to coronary artery disease were about 90 percent more likely to have a heart disease incident, like a heart attack, than those who were the least at-risk, genetically speaking.

Newer research, however, published February 2022 in Circulation, found that genetically at-risk people can stave off heart disease for up to 20 years by following a few basic healthy lifestyle habits.

"It's encouraging that, while we know genetics plays an important role in heart disease, it doesn't make heart disease inevitable," says Natalie Hasbani, MPH, the lead author of the study and a research assistant at UTHealth School of Public Health in Dallas. "You have a lot of tools at your disposal to combat high genetic risk, including taking control of your lifestyle."

There's also some overlap between genetic inheritance and lifestyle, says Christine Jellis, MD, PhD, a cardiologist at the Cleveland Clinic. For example, eating a poor diet, smoking or not exercising can also run in the family. "We have the same dietary and exercise habits as our families and pass those habits on to our children," she says.

How Often Should You Get Screened?

There's no single screening test for heart disease, but there are screenings to help you keep an eye on the biggest risk factors for the condition, including high blood pressure, high low-density liproprotein (LDL) cholesterol and obesity, per the CDC.

Some risk factors, like high blood pressure, don't cause any obvious symptoms, which makes screenings even more important. If ticker troubles run in your family, be proactive and set up a screening with your primary care doctor or a cardiologist based on the following guidelines:

High blood pressure: If you're at high risk for high blood pressure or you're over 40, get it checked once a year. If you're under 40 and not at increased risk, get it checked every three to five years, per the U.S. Department of Health and Human Services (HHS).
High LDL cholesterol: It's generally recommended to get a cholesterol check every four to six years, but if high cholesterol or heart disease runs in your family, you should get tested more often, per the HHS. Ask your doctor how often makes sense for you.
Obesity: Your doctor should use your weight at your annual checkup to calculate your body mass index, which will determine if you have overweight or obesity, per the American Heart Association (AHA). If your BMI is 25 or higher, they may also measure your waist circumference. A waist size greater than 35 inches for people AFAB or 40 inches for people AMAB is linked to a higher risk of heart disease, per the AHA.

In general, your doctor should tailor a plan to you and take "an evidence-based approach to looking at your cardiovascular risk factors," Dr. Jellis explains. This may mean checking your blood pressure, blood sugar and cholesterol levels, as well as other screenings, like an EKG or ultrasound, if necessary.

"It's always good to have a baseline checkup and then establish care with a trusted provider," she says. "That way, in the future, people always have someone that they can reach out to if their circumstances change."

6 Tips to Help Lower Your Risk of Heart Disease

Want to shore up your heart health? By adopting these healthy habits, you'll be well on your way to lowering your risk of heart disease, regardless of the genes you inherited.

1. Set a Bedtime Alarm for 10:00 p.m.

And then stick to it. Far from being harmless, getting too little shut-eye can be harmful to your heart. In a September 2019 study in the Journal of the American College of Cardiology, people who logged fewer than 6 hours of sleep each night had a 20 percent greater chance of having a heart attack than people who got 6 to 9 hours of sleep a night.

2. Eat More Salmon and Olive Oil

By now, you likely know that not all fats are bad for you. Monounsaturated and polyunsaturated fats — which are found in olive oil and salmon, respectively — are particularly heart-healthy, Dr. Jellis says. Plus, by eating more of these fats, you'll naturally replace some of the less-healthy saturated fat (found in meat and dairy) that should be consumed in moderation, she says.

Monounsaturated and polyunsaturated fats are found in abundance in the Mediterranean diet, which, according to a sweeping March 2019 review in Circulation Research, is linked to better heart health and lower rates of heart disease. Other staple foods of the diet include fish, vegetables, fruits, beans, nuts and seeds.

Fish may also be particularly good for people who already have heart disease. A March 2021 study in JAMA Internal Medicine found that eating about two servings of fish per week can lower the risk of having a heart attack, stroke and heart failure among people with pre-existing heart disease.

Aim to eat fish about twice a week, per the AHA, and make sure to choose fatty fish like salmon, tuna and mackerel.

3. Go for Walks

Even if that walk is just around the house. Replacing 30 minutes of sedentary behavior a day with even light-intensity exercise — like walking slowly or doing chores like dusting — could lower the risk of dying of heart disease by 24 percent, according to a January 2018 study in Clinical Epidemiology.

"The heart is like any other muscle — it needs to be exercised," says Dr. Jellis.

As your endurance levels pick up, you can also pick up the exercise pace. The AHA recommends getting 150 minutes of moderate-intensity exercise a week, or about 30 minutes a day, five times per week. Moderate- and vigorous-intensity exercise (think: biking, running) improves your heart's ability to pump blood and shuttle oxygen throughout the body, according to the National Heart, Lung, and Blood Institute.

4. Download a Meditation App

What's bad for your mood may also be bad for your heart. "Stress can be associated with developing heart disease," says Dr. Jellis. "In situations of high stress, people can take on unhealthy habits, like smoking or vaping, making poor diet choices and staying sedentary."

Practicing mindfulness — in which you're aware of your feelings and senses, but aren't judging them — is one way to relieve stress, according to an April 2016 paper in Clinical Psychology Review. Apps like Headspace ($13 a month, Headspace.com) and Insight Timer (Free, InsightTimer.com) offer guided mindfulness sessions that can teach you how to practice the technique throughout the day.

For example, some mindfulness techniques might include focusing on your breathing — paying attention as each breath comes in and out of your lungs — or paying more attention to sensations, like the feel of warm water as you wash dishes.