How to Prevent Heart Disease, Even If It Runs in Your Family

If your parents, siblings, or grandparents had or have heart disease, it’s not uncommon for my patients to wonder: Am I destined for the same fate?

While family history is a risk factor, it’s not a guarantee. Heart disease is influenced by a combination of genetics, lifestyle, and environment. And the good news is, you have control over more than you think!

Here’s what to know (and do) if heart disease runs in your family.

First: What Does "Runs in the Family" Actually Mean?

When we say heart disease is "genetic," we’re usually referring to inherited risk factors, such as:

  • High blood pressure

  • High cholesterol

  • Type 2 diabetes

  • Early heart attacks (in men <55, women <65)

If multiple close relatives have had heart problems, especially at younger ages, your risk is elevated. But it’s not just about DNA. What often gets passed down isn't just genes: it's also habits, environment, and beliefs about health.

That means prevention is still possible — and incredibly powerful.

You Can’t Change Your Genes. But You Can Change the Story.

Your genetic makeup might load the gun, but lifestyle pulls the trigger. Research consistently shows that modifying key behaviors can dramatically reduce the risk of heart disease, even for those with strong family histories.

 

Here's where to focus:

1. Know Your Numbers Early

The earlier you track your heart health, the better. Ask your doctor about:

  • Blood pressure

  • LDL and HDL cholesterol

  • Triglycerides

  • Blood sugar and A1c

  • Inflammatory markers (like hs-CRP)

  • Coronary artery calcium score (for some)

These numbers tell a story about your risk, and what steps to take now to reduce it.

If you have a family history of early heart disease, don’t wait until your 50s for a check-up. Start in your 20s (or even earlier).

2. Focus on What You Can Control

You might not control your DNA, but you can control:

  • What you eat

  • How often you move

  • Whether you smoke or drink too much alcohol

  • How you manage stress

  • Your sleep 

  • Whether you take prescribed medications

It’s not about being perfect. It’s about consistent, sustainable habits that support your long-term health.

3. Rethink “Normal” Habits

Sometimes, what feels “normal” in a family is actually part of the problem.

Do most meals center around processed or fried foods? Is physical activity rare? Are weight issues, stress, and high blood pressure common across generations?

These patterns can feel inherited, but they’re often learned. And the cycle can stop with you.

4. Don’t Wait for Symptoms

One of the scariest things about heart disease? It often progresses silently for years.

You may feel fine until something serious happens, like a heart attack. That’s why prevention is so important. With the right screenings, support, and positive lifestyle changes, you can spot issues early and make changes before damage occurs.

5. Team Up with the Right Doctor

A family history of heart disease is a reason to be proactive, not panicked. Working with a cardiologist who understands both the science and the psychology of prevention can help you personalize a plan, get the right labs and imaging needed, and keep you motivated throughout the journey.

 
 

You’re Not Powerless — You’re Prepared

Having a family history of heart disease doesn’t mean it’s your destiny. It means you’ve got a heads-up — and that’s a gift! So utilize this knowledge to the best of your ability. By being proactive, informed, and supported, you can make changes that protect your heart, add years to your life, and improve your day-to-day health right now. 

For a deeper look at the root causes of heart disease and how to prevent it, I share it all in my book Arteries in Harmony — a must-read guide to evidence-based heart health.

Megan ButcherComment