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Heart Disease: Genetic or Lifestyle ?
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IAmTheGlue
Posts: 701 Member
in Debate Club
What do you think? How much of heart disease is family history vs your chosen lifestyle?
I (45, F) had my DNA sequenced and I did not have the genes that indicate an increased risk of heart disease. But…. the men in my family have all died of Congestive Heart Failure. My cousin (basically my sister as we were raised together) and I were talking just two days ago about how both our Dads died of CHF, who else in the family has it, etc and how scary it was. We were discussing the steps we were taking to prevent us from going down that road. For example, heart healthy diet, exercise, trying to maintain a healthy weight… thinking if there was anything else we should be doing.
I was surprised to see no genetic component (for me at least)so is it literally just lifestyle for some folks? I have two more living uncles in my Dads side, both with CHF but… both are in their 60’s, confirmed bachelor’s who eat out for every meal…both are very top heavy… I don’t know what the proper term is but you know the 9 months pregnant look? I love them, I’m just saying I know that abdominal fat storage is a health concern.
I (45, F) had my DNA sequenced and I did not have the genes that indicate an increased risk of heart disease. But…. the men in my family have all died of Congestive Heart Failure. My cousin (basically my sister as we were raised together) and I were talking just two days ago about how both our Dads died of CHF, who else in the family has it, etc and how scary it was. We were discussing the steps we were taking to prevent us from going down that road. For example, heart healthy diet, exercise, trying to maintain a healthy weight… thinking if there was anything else we should be doing.
I was surprised to see no genetic component (for me at least)so is it literally just lifestyle for some folks? I have two more living uncles in my Dads side, both with CHF but… both are in their 60’s, confirmed bachelor’s who eat out for every meal…both are very top heavy… I don’t know what the proper term is but you know the 9 months pregnant look? I love them, I’m just saying I know that abdominal fat storage is a health concern.
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Replies
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First, I would take some of those DNA tests you get with a very large grain of salt unless you had a cardiologist order them looking for a very specific genetic link. (Well, maybe not, salt isn't great for the blood vessels...) I worked at one of those companies who sold those kinds of tests and depending who does it and what they're looking at the test may be more art than science.
Here's some fairly recent general science:
https://jamanetwork.com/journals/jamacardiology/fullarticle/2740282
I think you have the right mindset otherwise. Lots of fruit and vegetables, healthy fats, low saturated fats, exercise. Weight management - and I would add stress management like meditation, journalling, or prayer.
No one knows what's gonna kill us. There's a very long list of things that may get me! Both my parents died of heart issues, my dad was in his forties, mom in mid-sixties. That's two good reasons why I do the best I can with my choices. I also have a BP cuff I use twice a day.8 -
Many of the men in previous generations of my family had heart problems...heart attacks, strokes, high blood pressure, high cholesterol, CHF. But, they were also all overweight, smoked, did not exercise, drank a lot of alcohol, and ate diets of mostly red meat and few vegetables.
It's hard to say....none of us have had genetic testing. But, I would think that even if you did have a genetic predisposition to heart problems, you could greatly decrease your chances of developing them by adopting a healthy lifestyle.
Sometimes, there's only so much you can do to overcome genetics. My sister has high cholesterol. She eats a very healthy diet, is a normal weight, and runs marathons. Nothing that she can do seems to bring her cholesterol down. She'll have to start medication for it soon.
By contrast, I am also a healthy weight and eat a decent diet (not as careful as she is), and I exercise (not to the level of marathons), my cholesterol is very low. Even when I was overweight, my cholesterol was low. We are full siblings, so that's interesting to me.2 -
I don't think it is an either/ or question.
Both genetics and lifestyle play a part.
Some risk factors you cannot control : gender, age, family history.
You can control your weight, your activity level, smoking, alcohol intake, treat BP and cholesterol if required.6 -
@cmriverside , thank you for the article. I’m going to read that in a bit.
I had the testing done by the Mayo Clinic where I am a patient. I think they are legitimate as much as any one could be. I am going to read your article in a minute though.
I have two rare auto immune liver/bile duct diseases and unfortunately am already in early cirrhosis, so I do try to maintain a healthy lifestyle as much as possible.
Thank you all for your thoughts. I guess it is kind of like the nurture / nature debate…
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There are a few issues with genetic testing. Firstly, the genetic link to all diseases and conditions is not yet known (more are being found every day), so negative results really mean there are no genetic causes found at the moment.. Secondly, you can be genetically predisposed to a condition but you might need environmental triggers to cause it (I.e. some people will get COPD after smoking and some won’t). Sometimes you need a “switch” to turn the genes on. Ultimately even if you are predisposed, a healthy diet and sensible exercise will give you the best chance at coping / recovering. It sounds boring, but being fit and active is often the best defence 🤷♂️5
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Best of luck and good health to you, @IAmTheGlue2
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paperpudding wrote: »I don't think it is an either/ or question.
Both genetics and lifestyle play a part.
Some risk factors you cannot control : gender, age, family history.
You can control your weight, your activity level, smoking, alcohol intake, treat BP and cholesterol if required.
^^ this
I get most of my physical characteristics from my father. Both of us are tall and skinny, and both of us developed idiopathic hypertension in our early 30s. At the time I was a smoker but when I quit smoking at age 36 my blood pressure didn't budge. In my 40s I started to get more serious about my health, eventually transitioning to a pescetarian diet that is now over 50% fruit and veg. Made deliberate daily exercise a priority. And through all of these positive lifestyle changes my blood pressure continued to climb. I went from one med to two meds, to doubling the dose on the second med, and now at age 58 I'm on three meds. That keeps me around 134/94 ish, which seems to be as controlled as it gets.
My paternal grandfather (not overweight, nonsmoker) died of a heart attack. My paternal grandmother developed dementia as a result of multiple TIAs damaging her brain, and then congestive heart failure.
I think I can be pretty sure what's going to kill me in the end.6 -
I don’t know. I thought it was genetic. My dad and two sisters died from it.
First, aunt, 40 years of age, heart problems all her life. No weight problems.
Second, 25 years later? My dad, 70’s, first heart attack at 50. Tried to gain a little weight most of his life.
Third, aunt, 98, no heart problems until about 90. No weight problems.0 -
Here's an IMO kind of mind-bending perspective on thinking about genetic risk factors.
https://www.nature.com/articles/s41562-018-0483-4
The actual study is paywalled, but note the term "physiological" in the abstract, i.e., actual physical effect.
In brief, people's actual physical performance actually changed based on what they were told about their exercise-related genetics tendencies. The whole experimental group did an exercise test, were told about relevant genetic markers (half of them were told the opposite of what was true about their genetics), then did a repeat of the same test. In some cases, what they were told about their genetics had a stronger effect on performance than their actual genetics, basically. (They were told the truth afterward, BTW.)
Ditto for a similar test with satiety and information about satiety genetics. IIRC, they tested satiety hormones in the bodies, not just used subjective evaluations.
This podcast has a consumer-friendly explanation of that and other relevant (but surprising) research:
https://hiddenbrain.org/podcast/reframing-your-reality-part-2/
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My dad is adopted and I don't know anything about his family history which scared me a bit. I do have high cholesterol despite have a relatively healthy diet low in saturated fats/salts/cholesterol. My high cholesterol is genetic though and my doctor told me I didn't need statins unless I had diabetes or high blood pressure. My mom has high blood pressure and heart disease runs on her side of the family. Even when I was obese I had high cholesterol and the only thing that actually changed was my blood pressure. It used to be high and now I have a healthy BP. Sometimes it's low. What I'm getting at is that genetics and lifestyle both matter and I don't think one is necessarily more important than the other. But if you know heart problems run in your family, it doesn't hurt to see a cardiologist at least once a year. I still worry about CHF even more so since my best friend died at 32 of CHF (she was also obese and had issues with alcohol). Anyways, just keep doing what you can and checking up with your doctors 💕0
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If it was mostly genetic then the curve for heart disease in the 20th century shouldn't have been as dramatic with the increased incidence especially mid century. Primary prevention as it improved has slowed mortality. imo4
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For some there is a strong genetic component. I see occasionally young people with cardiomyopathies or valve disorders despite no unhealthy habits and being normal weight or even fit. Some high cholesterol and high blood pressure is also genetic and can’t be controlled with diet and lifestyle and those are two things that really increase heart disease risk.
But for many it is about lifestyle. Meth, alcohol, and smoking are horrible for the heart among other things like saturated fat and sedentary lifestyle.1 -
But for many it is about lifestyle. Meth, alcohol, and smoking are horrible for the heart among other things like saturated fat and sedentary lifestyle.
Well, since you brought recreational drugs into the conversation
cocaine is another bad one. I'm old enough now to see the negative effects of youthful coke use showing up in some peers. They've adopted healthier lifestyles later in life but the damage was already done. 1 -
But for many it is about lifestyle. Meth, alcohol, and smoking are horrible for the heart among other things like saturated fat and sedentary lifestyle.
Well, since you brought recreational drugs into the conversation cocaine is another bad one. I'm old enough now to see the negative effects of youthful coke use showing up in some peers. They've adopted healthier lifestyles later in life but the damage was already done.
Oh yeah, for sure! Scary how much drugs can damage the heart and other things.
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Here's an IMO kind of mind-bending perspective on thinking about genetic risk factors.
https://www.nature.com/articles/s41562-018-0483-4
The actual study is paywalled, but note the term "physiological" in the abstract, i.e., actual physical effect.
In brief, people's actual physical performance actually changed based on what they were told about their exercise-related genetics tendencies. The whole experimental group did an exercise test, were told about relevant genetic markers (half of them were told the opposite of what was true about their genetics), then did a repeat of the same test. In some cases, what they were told about their genetics had a stronger effect on performance than their actual genetics, basically. (They were told the truth afterward, BTW.)
Ditto for a similar test with satiety and information about satiety genetics. IIRC, they tested satiety hormones in the bodies, not just used subjective evaluations.
This podcast has a consumer-friendly explanation of that and other relevant (but surprising) research:
https://hiddenbrain.org/podcast/reframing-your-reality-part-2/
Ah, yes, you mentioned this podcast on another thread. I listened to parts 1 and 2 and found them very interesting, and the part about good stress was very helpful for a stressful meeting I had within a week of listening.1 -
I think it's both, but certain genetics may make us more prone to suffer issues.
For example, as far back as I am able to trace, stroke has killed the women on my maternal side. Both of my parents have had BP issues most of their adult lives. Osteoporosis runs in the maternal family as well, and my mother has it very bad.
Therefore, knowing this, when (not quite a year ago) I had a BP wake up call (went to donate plasma but my bp was too high - way higher than anything I had ever seen before), I immediately started implementing some lifestyle changes, including finding a reliable way to reduce my stress (which was culprit #1).
I'm also a bit more "aware" of this family history, and especially at my age, am more determined than ever to not follow in my family's footsteps. Almost everyone on my mother's side is overweight to obese and have been most of their lives. Many have smoked for years. Alcoholism runs in both sides of the family.
Thankfully I've always been more active and have worked out/lifted/done physical jobs most of my life, unlike many in my family (exception being my father who has stayed active into his 70's now). I've also never struggled with obesity, but I've yo-yo'd the 15-25 pounds I could stand to lose for years - and now that I've figured out the stress thing and have developed that into a lifestyle, deciding to take care of my fluff is my priority #1 - carefully and sustainably, but get it off and quit with the back and forth poo I've been pulling for years.
I don't know that I'd be trusting some "genetic test" unless it was done through a doctor, I'd be looking at that family history, recognizing what I may be more susceptible to, and living accordingly.0 -
A bit late to this, but for anyone who is interested, there are some really interesting studies that were done on twins who were raised separately, looking at differences vs. similarities for physical and mental conditions, etc...
Basically, they are finding what a lot of people suspect, which is that some things seem to be more genetically influenced, and some more environmentally influenced. I can't recall which factors pinged more one way or another any more, but it's worth hunting down the studies, if you are curious, because some things really seemed heavily correlated with genes or environment, but not both.0 -
I saw an interesting sports documentary on research in getting the next olympic champion and selecting and training the right people recently, hosted by a former pro. There are a couple of genes that might make you an amazing sprinter, or long distance runner, or lifter. But if you don’t activate the genes early on in life then you could be the next ben johnson but be totally useless at sports if you never exercised as a child. I could imagine that the same is true for quite a few other things: if lifestyle is good your chance if developing heart disease are a lot smaller to absent.Here's an IMO kind of mind-bending perspective on thinking about genetic risk factors.
https://www.nature.com/articles/s41562-018-0483-4
The actual study is paywalled, but note the term "physiological" in the abstract, i.e., actual physical effect.
In brief, people's actual physical performance actually changed based on what they were told about their exercise-related genetics tendencies. The whole experimental group did an exercise test, were told about relevant genetic markers (half of them were told the opposite of what was true about their genetics), then did a repeat of the same test. In some cases, what they were told about their genetics had a stronger effect on performance than their actual genetics, basically. (They were told the truth afterward, BTW.)
Ditto for a similar test with satiety and information about satiety genetics. IIRC, they tested satiety hormones in the bodies, not just used subjective evaluations.
This podcast has a consumer-friendly explanation of that and other relevant (but surprising) research:
https://hiddenbrain.org/podcast/reframing-your-reality-part-2/
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