Heart Attack and Family History


There is some tendency for arterial narrowing, involving especially the coronary arteries and the cerebral arteries (which feed blood to the brain and whose narrowing causes strokes), to run in families. There is obviously not a great deal that can be done about this. If you have it in the family you may be stuck with it! A family trait however is not especially strong so there is no need for undue worry, but it does mean that attention to other risk factors is even more important.

On the other hand, if the family trend is very bad, for example several members of the family having or dying from heart attacks at a young age, and especially if it involves several generations and women in the family (in which it is unusual before the menopause) it may be due to a profound abnormality of blood cholesterol or related body fats, which can be diagnosed easily in a blood sample taken after fasting. Such people may have a very high blood level of cholesterol or the related substance triglyceride, and it is now known that treatment with a diet, drugs, or both, can have a favorable effect on the risk of coronary attacks. It should be emphasized however that this type of abnormality is very rare.

Raised cholesterol as a risk factor, except in those very profoundly abnormal patients, is of doubtful importance. Quite a lot of publicity has been given to it over the years, but it is still controversial whether the small rises of cholesterol and triglycerides which are found in many people are of any significance. Many doctors nowadays feel that its importance has been overestimated and that attempts to decrease the intake in the diet are not all that helpful. It seems surprising that although many years of research has been carried out the answer it still not clear cut Many feel that in this current state of uncertainty it is wise to adopt a so-called “prudent” diet where the in-take of certain dietary fats – particularly saturated fatty acids is reduced.

The diet involves the reduction of animal fats and dairy products. Fat on meat is reduced and vegetable oils used for cooking. Special margarines which are rich is so-called polyunsaturated fatty acids are used, and a reduction is made in the amount of milk, cheese, cream and eggs. The evidence that taking this diet to extremes is helpful is really lacking, but for the time being diets of this type is considered “prudent”.