Heredity and Heart Disease

Heredity - The genetic variables that influence the development of CARDIOVASCULAR DISEASE (CVD). Some forms of cardiovascular disease are entirely hereditary and develop without influence of lifestyle factors. Among them are hypertrophic CARDIOMYOPATHY, LONG QT SYNDROME (LQTS), WOLFF-PARKINSON-WHITE SYNDROME, and familial HYPERLIPIDEMIA. There appear to be few interventions, medical or lifestyle, that can prevent these conditions. Early diagnosis allows for optimal medical management. Researchers suspect that undiagnosed hereditary conditions, notably ARRHYTHMIA disorders, account for up to 25 percent of SUDDEN CARDIAC DEATH in the United States.

Congenital malformations of the HEART often accompany GENETIC DISORDERS or CHROMOSOMAL DISORDERS. Septal defect is common in children who have DOWN SYNDROME (trisomy 21), for example. Most people who have MARFAN SYNDROME, a hereditary connective tissue disorder, have cardiovascular abnormalities including malformed heart valves and arterial walls that lack connective tissue, weakening them and making them vulnerable to ANEURYSM.

As well, there are correlations, though researchers do not fully understand them, among BIRTH DEFECTS involving the heart that occur in conjunction with specific birth defects affecting other body structures. About a third of infants born with ESOPHAGEAL ATRESIA (incomplete formation of the ESOPHAGUS) also have the heart malformation patent ductus arteriosus (PDA). Heart malformations are also common in children who have NEURAL TUBE DEFECTS such as SPINA BIFIDA. These correlations strongly suggest GENE mutations.

Gender and race are other hereditary factors that influence the development of cardiovascular conditions. Men, until about age 60, have three to five times the risk for CORONARY ARTERY DISEASE (CAD) and HYPERTENSION (high BLOOD PRESSURE). Men under age 60 are also more likely to have HEART ATTACK or STROKE. The risk for cardiovascular disease is exponentially higher among African Americans. Hypertension is the leading cause of stroke and kidney failure among African American men between the ages of 35 and 50.

Other forms of cardiovascular disease that tend to “run in the family” may have genetic underpinnings that manifest with interplay from certain lifestyle factors such as cigarette smoking, lack of physical exercise, and eating habits. Such cardiovascular conditions include hypertension (high blood pressure), ATHEROSCLEROSIS, CAD, and PERIPHERAL VASCULAR DISEASE (PVD). Evidence is very strong that appropriate lifestyle interventions can delay or even prevent the onset of such conditions despite any genetic predisposition.


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