Genetic Factors in Heart Disease: Understanding Family Impact

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1 Heart Disease: A General Overview Including Genetic Factors and Family History Family History Robert Shupe Department of Biology, Farmingdale State College BIO 121: Health, Heredity, and Behavior Professor: William J. German April 10, 2024

2 Heart Disease: A General Overview Including Genetic Factors and Family History The following research paper will discuss heart disease, also known as cardiovascular disease, emphasizing genetic factors related to family history. Unfortunately, this silent killer is prevalent across America. In order to better understand why, an analysis regarding aspects such as morbidity and mortality, inherited risk, and behavioral factors is warranted. Heart Disease Defined Let us begin by going over what Heart disease is and why it has become an ever- increasing medical dilemma for Americans today. As simply described by the National Cancer Institute, it is a “type of disease that affects the heart or blood vessels. The risk of certain heart diseases may be increased by smoking, high blood pressure, high cholesterol, Triglycerides, unhealthy diet, lack of exercise, and obesity. The most common heart disease is coronary artery disease (narrow or blocked coronary arteries), which can lead to chest pain, heart attacks, or stroke. Other heart diseases include congestive heart failure, heart rhythm problems, congenital heart disease (heart disease at birth), and endocarditis (inflamed inner layer of the heart), and also called cardiovascular disease” (heart disease, n.d.). Therefore, it is essential to understand that heart disease covers several underlying cardiovascular problems that may arise in patients. . 3 Historical Data

A quick search for information on the internet revealed some rather interesting historical facts. Researchers were able to determine that heart disease was detected in Ancient Egyptian society around 1580 BC. Concerning American society, according to the American College of Cardiology, “heart disease was uncommon before the 19th century, but soon became the leading cause of death by mid-century. Also of note is that deaths have been declining in number since the mid-1960s, likely due to declines in tobacco use as well as better diagnostic testing and treatments ( The history of heart disease dates back to Egyptian pharaohs n.d.). By the early 1960s, hospitals began opening cardiac care units, and defibrillator technology became available to shock the heart back into a normal rhythm. Symptoms - Diagnosis Symptoms of heart disease include shortness of breath, heart palpitations, sweating, lightheadedness, chest or upper body pain, neck pain, vomiting, exhaustion, and difficulty sleeping. Swelling of the legs and repeated fainting are also early warning signs. Heart disease is detected via health care professionals utilizing personal and family history and testing. Besides blood tests and standard X-ray imaging, doctors may utilize ECG/EKG, cardiac CT or MRI scanning, stress exercise testing, and echocardiograms. 4 Morbidity-Mortality Data

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Of all the vast amount of information available on the subject, the most significant data fact to stand out is presented by the World Health Organization. According to the WHO, “Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age” (World Health Organization, Cardiovascular diseases n.d.). Within the United States, the CDC lists heart disease as the number one killer for men, women, and people of most racial and ethnic groups. This equates to having someone die every 33 seconds and accounts for 1 out of every five deaths. In 2021, nearly 665,000 people died due to cardiovascular disease ( Heart disease facts 2023). Of note is the fact that women age 50 or below are two times more likely on average to die from heart disease than men, and the southern United States has some of the highest death rates when comparing regions (Thomas, 2023). Furthermore, it is estimated by the CDC that as of 2018, more than 30 million Americans have a diagnosis, and every year, another 805,000 citizens will have a heart attack. 5 Inherited Risk Factors

For a better understanding of risk factors, it is necessary to take into account an individual’s family history as well as possible inherited gene mutations. It’s possible that one or more gene mutations can cause an individual to have a likelihood of high blood pressure, abnormally high cholesterol levels, heart dysrhythmia, and even heart muscle disease. According to the CDC, “Genetic testing, sometimes called genomic testing, can be used to find out whether an alteration in one (or more) of your gene(s) could lead to an inherited heart condition (IHC). A genetic test often involves a blood test. However, it can also be carried out on a sample of hair, skin, or tissue ( Heart disease, family health history, and familial hypercholesterolemia 2023). My grandfather had heart disease and went through quadruple bypass surgery; he has high Triglycerides. Having “High triglycerides” can be a problem which can Increase your chances of having heart disease. Triglycerides got less attention when looking at cardiovascular risk compared to “LDL” and “HDL cholesterol levels.” If it is determined that a patient has a family history of heart disease, especially members age 50 or younger, doctors can run a genetic disorder called hypercholesterolemia, a disorder that causes high cholesterol. Early detection can obviously lead to medical and lifestyle changes for an improved outcome... 6 Behavioral Factors

Although genetics can serve to greatly increase the likelihood of having heart disease, lifestyle, diet, and exercise can be helpful in limiting the risk. That being said, environmental factors, as learned and inherited from family social structures, are also at play. The American diet is filled with fatty foods that only assist in producing adverse health effects. Lack of exercise due to our modern society is also a contributing factor. This also includes unhealthy habits such as tobacco use and harmful drug and alcohol use regularly. These lifestyle risks can show up medically in high blood pressure, high lipids, diabetes, high blood glucose tests, and physical appearance as weight and obesity issues. Treatment There is a lot of information regarding the treatment of heart disease. That being said, according to MedicalNewsToday, treatment includes “options will vary depending on the type of heart disease a person has, but some common strategies include making lifestyle changes including exercise and healthy diet choices, taking medications, and undergoing surgery.” Some examples from Medical News Today for heart disease treatments are “Anticoagulants Also known as blood thinners, these medications can prevent clots. They include warfarin (Coumadin) and the direct oral anticoagulants dabigatran, rivaroxaban, and apixaban.”. Some notes of interest include medical science saying that taking Aspirin immediately after a suspected heart attack can limit damage to the heart organ. Also, spending time with loved ones and getting an annual flu shot are believed to help lessen the risk of further heart complications in patients. These are some nice examples of how you treat heart disease correctly so as to avoid 7

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decline over time. Without intervention and treatment, cardiovascular disease can possibly have a severe negative impact, especially for those in their senior years. Future Trends Going forward, advancements in the prevention of cardiovascular disease look promising. Current trends involve using Artificial Intelligence and machine learning to improve prevention through personalized risk assessments and overall data patterns for at-risk groups. Also of interest are advances in smart wearable technology for monitoring patients to further medical insights for CVD and improvements in imaging for detection (Javaid et al., 2022). References Centers for Disease Control and Prevention. (2023, May 15). Heart disease facts . Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/facts.htm Diagnosing Heart Problems Is the First Step In Managing Disease: Evaluation of cardiac risk factors can lead to earlier diagnosis and life-saving treatment. (2024, January) . Women’s Health Advisor, 28(1), 3. https://0-link-gale-com.search.livebrary.com/apps/doc/A781038044/ITOF?u=nysl_li_s cls&sid=bookmark-ITOF&xid=d5be71fd 8

The history of heart disease dates back to Egyptian pharaohs. Baystate Health | Healthcare in Western MA. (n.d.). https://www.baystatehealth.org/news/2022/02/history-of-heart-disease#:~:text=The%2 American%20College%20of%20Cardiology,common%20in%20ancient%20times%2t Javaid, A., Zghyer, F., Kim, C., Spaulding, E. M., Isakadze, N., Ding, J., Kargillis, D., Gao, Y., Rahman, F., Brown, D. E., Saria, S., Martin, S. S., Kramer, C. M., Blumenthal, R. S., & Marvel, F. A. (2022, August 29). Medicine 2032: The Future of Cardiovascular Disease Prevention with Machine Learning and Digital Health Technology . American journal of preventive cardiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9460561/ Kilbane, C. (1995, February). A closer look: Americans at risk for heart disease and stroke. Total Health, 17(1), 45+. https://0-link-gale-com.search.livebrary.com/apps/doc/A16224771/ITOF?u=nysl_li_scl Know your risk: Family history and heart disease. Know your risk: Family history and heart disease | Heart Foundation . (n.d.). 9

https://www.heartfoundation.org.au/your-heart/family-history-and-heart-disease Komaroff, A. L. (2004). By the way, doctor. Why do doctors try to determine if a person has heart disease by asking about smoking, high cholesterol, or family history? Why can’t they just examine the heart and blood vessels directly, and get a precise answer? Harvard Health Letter , 29 (3), 8. NCI Dictionary of Cancer terms. National Cancer Institute. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/heart-disease Manchester, R. A., McDuffie, C., & Diamond, E. (1989). Screening for hypercholesterolemia in college students. Journal of American College Health : J of ACH , 37 (4), 149–153. https://doi.org/10.1080/07448481.1989.993840 Thomas, J. (2023, July 20). Facts and statistics on heart disease. Healthline . https://www.healthline.com/health/heart-disease/statistics#Who-is-at-risk? 10 World Health Organization. (n.d.). Cardiovascular diseases. World Health Organization . https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1 https://www.health.harvard.edu/heart-health/should-you-worry-about-high-triglycerides

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