Family history of CVD

Medical Q&A [Moderated]
1

Hi guys, I’ve got a question about family history of CVD,

My father died from a heart attack at 58 and both of his parents also died in their late 50s from heart attacks. It’s worth noting that my father smoked 20+ cigarettes a day for 40 years, was obese, didn’t exercise, didn’t eat a particularly good diet and overconsumed alcohol quite frequently.

On the other hand, I live a completely different lifestyle, exercise often, control my weight, don’t smoke, sleep well, rarely drink etc.

My mother’s parents are both in their 90s but I’m somewhat concerned that I may have my father’s genes for CVD risk. Some basic stats below

Age: 28
Height: 5 foot 9
Weight: currently 177lbs but generally cut/bulk between 160 and 180
BMI: currently26.2 but ranges between 23.7 and 26.5 depending on whether I’m “bulking or cutting”
Bodyfat % : Probably in the region of 20% but spend most of the year closer to 12-15%
Waist: currently 37 inches (goes down to about 34-35 when I’m at my leanest)
Hips: 40 inches

Resting heart rate: mid 50s
Blood pressure 105/60

Training age/history: 10 years

So now you have background info my questions are:

  1. My usual weight gain approach is to cut down till I have a fairly visible abs (about 34 inch waist for me as I tend to be quite blocky around the midsection) and then slowly gain weight at a rate of about 0.5lbs a week until I hit a 37 inch waist. Is this approach suitable or do you think it would benefit me to maintain a lower average waist size ?

2. Given my family history, at what age do you think it would be appropriate for me to go to my doctor and get a cholesterol panel done ? And what numbers would you like to see ?

  1. I tend to carry a large proportion of my bodyfat around the love handle/lower abdominal region. I can have very vascular arms, good all over muscle definition/shape, see the top 2 rows of my abs perfectly, but still have a bit of a “spare tyre” around the lower abdominal region. Does this mean I should aim for a lower BMI than the average person as my fat is in the “wrong place” ?

4. Are there any other tests worth getting done at the moment ? blood sugar, inflammation etc

Thanks in advance,

Tom

2

  1. With the information you’ve provided, this is probably a reasonable approach. If you’re found to have underlying metabolic issues (e.g., significant blood lipid abnormalities), I may bias things to a lower waist range.

  2. Yes. Ideally a non-HDL-C < 130 mg/dL as a starting point.

  3. I wouldn’t be “aiming” for BMI targets in you. This is a good reason to use the waist circumference.

  4. I would leave this up to your primary care doctor, who should be following current guidelines with respect to age-appropriate testing. Prevention TaskForce Search . I would not test for “inflammation”.

3

Thanks Austin, I will be making an appointment with my doctor

All the best

Tom