Family History of Heart Disease - What do?

Hi Docs,

Both my father and grandfather died unexpectedly of heart attacks at age 72 and 65, respectively. In the case of my father, there were no significant warning signs although I did find out later he did have hypertension. He was a relatively healthy individual. Easily met the physical activity guidelines except for resistance training (couldn’t convince my parents on that piece), hadn’t smoked in 40 years, social drinker (In Canada, for men, low risk guidelines 15 drinks a week for men, with no more than 3 drinks a day most days. He met those.), and relatively decent diet. Looking at your health priorities article, he would have met most conditions except maybe saturated fat due to red meat consumption.

When I look at your health priorities article (awesome resource by the way), that is how I try to live my life. I’m 49 y/o, 6" 1", 210-215 lbs, 36 in waist. I was trying to gain some weight, but after listening to all of Jordan’s IG lives, I understand that my waist circumference is such that it’s not recommended, so I’ll stay at this weight and try to get as strong as possible here. I’ve been training consistently for the last 2 years and was 210 / 142.5 / 240 kg at my most recent meet. I have a lifetime goal of a 500 squat - hope to get there some day.

I really try to follow the health guidelines laid out in your article. The only one I probably need to check in on is the saturated fat intake because we do eat red meat and processed meat more than 3x / week. I’m working on it, but it’s a bit challenging as my kids have come to prefer the read meat meals. I had blood work done recently and my non hdl-c was 122 mg/dl up from 113 five years ago. My blood pressure in the doctor’s office that day was 138 over . But, at home, in measurements throughout the day it’s in the mid to high-120’s systolic and diastolic is 75-80.

Anyways, I wonder if there are additional screenings that I can undergo or what I should do to minimize the same fate as my predecessors. The only additional ‘screen’ my doctor did was an ‘absolute CVD risk/benefit calculator’ which showed an additional 1.9% of additional events ‘caused’ by risk factors on top of 6.2% baseline events. So, over the next 10 years, chance of an event for people with my risk profile is 8.1%.

Be interested to know what you think.

Many thanks for all you guys do.

Rod

Hi there,

Glad to hear you’ve found our content helpful when it comes to prioritizing your health.

It sounds like you’re doing quite well overall right now, and that the main area for improvement may involve adjusting the dietary fat sources a bit (this assumes you’re also regularly hitting the dietary fiber target, which we would strongly recommend as well).

Regarding what additional steps to go through, there aren’t many, to be honest.
-I would want to feel a bit more confident that your blood pressure is indeed normal (which would involve additional readings).
-If your 10-year risk estimate is currently 8.1%, it is reasonable to get a CAC score performed (this can help guide decision making with respect to how aggressively we manage an individual’s blood lipids, for example).
-Various clinical guidelines are increasingly adopting a recommendation that everyone undergo a one-time Lp(a) screening blood test, as this is a different independent risk factor for CVD that would require unique management.

That’s about I!