How genetics and family history can reveal your hearts disease risk

Heart disease remains the leading cause of death in Pennsylvania and across the U.S. While lifestyle factors like smoking and high cholesterol contribute to cardiac risk, your DNA and family history may offer the most powerful clues.

At Main Line Health, cardiologists are embracing the latest in genetics to help patients prevent heart problems before they start.

"Early detection can change the trajectory," says John Clark, DO, cardiologist at Main Line Health. "You have the chance to modify your future."

A personalized approach to heart health: Main Line Health's Genetics and Risk Assessment Program

Main Line Health's Cardiovascular Genetics and Risk Assessment Program provides proactive care, including comprehensive evaluations, conducting genetic testing and tailoring a prevention plan specific to your risks.

"We're not just identifying risk factors," says Cristina Nixon, MS, CGC, a certified genetic counselor. "We're giving patients real steps to reduce their risk — and empowering their families, too."

Why your family history of heart disease matters

Understanding inherited heart disease starts by digging into your family health history. Many conditions — like high cholesterol or early heart attacks — tend to run in families, but they're not always labeled clearly in the past.

Instead of a vague mention of a "heart attack," patients should work with their family and care team to identify exactly what happened, when and how it was treated.

Start by asking questions like:

• Did they have heart disease, high cholesterol or high blood pressure?
• Did they have a pacemaker or defibrillator?
• At what age did symptoms or conditions begin?

Gather this information and bring it to your cardiologist. Patterns such as heart attacks before age 55 can signal inherited conditions like familial hypercholesterolemia or genetic predisposition to heart disease.

What genetic testing can tell you about your heart risk

Genetic testing goes beyond family history — it identifies specific genes linked to cardiovascular conditions. At Main Line Health, this can include:

• Lipid disorders (like familial hypercholesterolemia)
• Aortopathy (weakened aorta walls)
• Cardiomyopathies (weakened heart muscle)
• Channelopathies (heart rhythm conditions)

With this data, your care team can create a custom plan that may include:

• Advanced screenings like cardiovascular imaging
• Heart rhythm monitoring
• Lifestyle recommendations (diet, exercise, stress management)
• Preventive medications

"We know that interventions with lifestyle changes or certain medications can actually decrease your risk of progression to symptoms or worsening of that condition," says Dr. Clark.

Why early genetic testing matters — even for children

"Most people don't think to check young kids for high cholesterol," says Nixon. "But if a parent has a genetic condition like familial hypercholesterolemia — which causes very high 'bad' cholesterol — it's smart to start testing their child's cholesterol around age eight. The sooner we catch it, the sooner we can lower those levels and reduce the risk of heart problems later in life."

Even ruling out a genetic condition can be helpful, saving patients from a lifetime of unnecessary monitoring, medical appointments and anxiety.

Genetic testing can protect your whole family

If you test positive for a gene mutation, your immediate family members (parents, siblings and children) each have a 50% chance of having the same mutation.

That's why genetic counselors often recommend screening other relatives to understand and reduce family-wide risk.

"We're not just helping the person in front of us," says Dr. Clark. "We're helping their entire family."

Take the first step toward personalized heart health

Preventing heart disease starts with understanding your personal and family history. Here's how to take action:

1. Talk to your family —  Ask about ask about any heart-related conditions they've had, when those issues began and whether there are any patterns, like high cholesterol, heart attacks or strokes at a young age.
2. Meet with a doctor —  Share what you've learned with your primary care physician or cardiologist and ask about genetic counseling or additional screenings.
3. Consider screening for your children — Especially if there's a strong family history.

Remember: Your genetics are a guide — not a guarantee. With the right information, you can take steps today to protect your heart tomorrow.

Next steps:

Make an appointment with John Clark, DO
Make an appointment with Cristina Nixon, MS, CGC
Learn more about heart and vascular care
Learn more about cardiovascular genetics and risk assessment