Talking to Family About the Genetic Risk of Heart Disease

While the development of some types of heart disease can be somewhat within our control in terms of lifestyle factors, there are also many elements beyond our control that can lead to developing them as well. Put simply: genetics. It can be a sensitive topic with family members due to fear, guilt, and grief from passing certain genes on, but it is imperative to know your genetic risk and talk to your family.

What is inherited high cholesterol?

I can’t speak to all of the genetic predispositions to developing cardiovascular disease, but I can speak to one of them: familial hypercholesterolemia (FH), or inherited high cholesterol.

FH is a genetic disorder that prevents the body from clearing out excess LDL ("bad" cholesterol" and therefore causes very high cholesterol levels. Excess LDL cholesterol can build up over time, leading to plaque and blockage in the arteries, which increases the risk of heart attacks and strokes.¹

FH is written in my genetic code

I found out that I had FH a year after losing my petite, outwardly-healthy Mom to a single heart attack. It became clear that my case was genetic as well, being an 18-year-old, petite, active girl.

Upon receiving the diagnosis, the doctors asked many questions about my family history, telling me that this was a disorder that was written in my genetic code, not anything that I’ve put on myself due to my lifestyle. They made it clear that my extended family should be in open communication about this inherited issue.

Fostering open communication with family

Here are my 5 tips for having open communication with family members around the sensitive topic of inherited heart health issues:

1. Let it be uncomfortable

These types of conversations are often avoided due to the difficult emotions that are present. Sadness and grief may surface if you’ve lost a family member to heart disease. Guilt may take over if someone passed the gene on to you.

These conversations will be uncomfortable, so the first step is to let them be. Fully accept the discomfort, and have them anyway. A mantra I use in uncomfortable situations is, "This is what discomfort feels like." It’s a simple way to admit that it’s uncomfortable, and it’s okay.

2. Lead with love

With discomfort, there must be love. Let your family members know that you’re here for them and you’re a team. Using sentences like, "I know this is uncomfortable to talk about, and it means so much to me that you’re willing to have this conversation. We are in this together!" can totally change the energy of the conversation.

3. State the facts

Bring statistics into your conversation. Share how serious these things are. Statistics can help people realize they are not alone and illustrate how seriously this needs to be taken.

4. Form a plan

Whether it’s making a doctor’s appointment, getting a procedure, starting a medication, or implementing some healthy lifestyle changes, developing a plan that involves your family members can be super beneficial. It solidifies the feeling that you are in this together and provides accountability.

5. Stay updated

Have regular conversations. Have yearly check-ins with your family after getting your yearly physical. Start a family group chat where you keep everyone in the loop about your latest test results.

Involving family members in these difficult conversations not only makes navigating your health easier, it also has the potential to impact their wellbeing, too!