Dr. Starling shares the familial factors that will increase a woman's risk for heart disease. Dr. Mark Starling studied medicine at the University of Washington School of Medicine and now practices at Banner Heart Hospital in Mesa, Arizona.
Family history is related to heart disease in general, in many different ways. For example, if you are a woman in her 40s or 50s and you had a father who had a heart attack, for example, in their 50s, or your mother had a heart attack in her late 50s, that would be considered premature heart disease.
You, in your 40s, because of that lineage, are at risk for heart disease as well. That’s one example. It’s what we call sort of inherited in very odd sort of way. It’s multiple genes and that we call it variable penetrance, so it’s a variable degree to which the genes express themselves. So that can be affected by the environment, what you do, your diet, your activity level kind of vary the expression of those. So it’s sometimes very difficult to kind of put a fine point on it, but it is evident that that’s the case.
Now, in heart failure in specific, we have learned over the last few years that we thought at one time that so much of what our systolic heart failure, our weakened pump, you know, those low ejection fractions in the 30% range or 25% range were really do, we thought it was all due to viruses. Influenza virus, it was due to kind of other kinds of viruses in the spring and summer that were different from those in the winter and that it was all viral or since we are medical people, we just had to put a name on it so we just put kind of unknown.
But what we have learned is there are a number of genetic defects that are inherited that make people susceptible to weakened heart muscles and there’s a wide array of them that has become evident over the years.
So again, the same sort of strategy; if you have a parent who in their 40s or 50s developed heart failure with no other reason imaginable, one of the suspicion should be that the potential for genetic inheritance, and it’s variable just like we have said with the heart attack, it’s kind of variably penetrant and some of them are very specific gene defects; others aren’t, but that whole big bag of patients who have these low ejection fractions at early ages with no known cause, many of them turn out to be genetic, again, marked by a parental or a sibling kind of an indicator, if you will.
If they had it then maybe you are susceptible to it and therefore, you have to watch your risk factors more carefully, you’re more careful with what you do, exercise, activity – all those other things become enhanced. If you have risk factors of high blood pressure or diabetes and you have a genetic tendency because your mother died with unknown heart failure at the age of 40, not only do you have a risk, genetic risk for it, but you also have risk factors for it.
Well you can’t change your genes, but you can change your risk factors. So you go and you focus on handling what you can control to prevent the future problem and that’s how you have to deal with it.
About Dr. Mark Starling, M.D.:
Dr. Mark Starling graduated from the University of Washington, B.A. Degrees, cum laude, History and Literature. After a studying French Language and Literature at the University of Paris in France, Starling returned to Washington to study medicine at the University of Washington School of Medicine. He graduated in 1974 with honors. Over the years, Dr. Starling has been that Associate Professor of Medicine in the Departments of Internal Medicine and Cardiology Division at both the University of Texas and the University of Michigan.
Conditions: Heart Failure, Heart Disease, High Blood Pressure,
Related Terms: Shortness of Breath, Ejection Fraction, Edema, Exercise Intolerance, Fatigue, Echocardiogram, Electrocardiogram, Weak Heart Muscle
Expert: Dr. Mark Starling, Dr. Mark Starling, M.D., Doctor Starling, Chief Medical Officer Mark Starling, Women's Heart Health Specialist Cardiologist Dr. Mark Starling
Expertise: Peripheral Artery Disease, Heart Disease Risks, Heart Disease Management, Cardiac Metabolic Syndrome, Heart Disease Prevention, Blood Pressure Testing, Cholesterol Testing, Robotic Catheter Ablation, Coronary Artery Disease, Heart Failure Warning Signs, Heart Failure Prevention