March 14, 2019

What do you need to know about your family health history?

Maybe your particular cocktail of genes gave you your mom’s sense of humor, your dad’s brown eyes and your grandma’s curly hair. But did you also inherit the genes that put you at greater risk for certain diseases?

While only genetic testing can answer for sure, it’s a good idea to know as much as you can about your family’s health history.

“I think understanding your family history is the best way to learn about what might potentially impact your health down the road,” said Kate Orland, MS, CGC, a genetic counselor with UW Health’s Inherited Arrhythmias Clinic. “It may or may not make a difference, but family history can be a really powerful indicator, particularly in cancer risk and cardiovascular disease. You don’t know until you ask.”

Tips for finding out your family's health history

Orland, who is one of a handful of cardiac genetic counselors in the U.S., shares these tips for capturing and understanding the most important aspects of your family’s health history:

Keep it natural

It can feel awkward to pry into relatives’ medical issues, so approach health questions as part of your family’s overall story and ask follow-up questions when death or illness naturally come up in conversation. “I encourage patients to phrase it in ways like, 'Why did so-and-so pass away?' or 'Why was so-and-so in the hospital?' instead of asking, ‘Why do you go to the doctor?' which sounds kind of nosy," Orland said.

Make it a two-way conversation

Start by sharing about your own health issues. "Being open with your own health history sets the tone for that conversation, and it’s valuable information for everyone in the family to have, even if it’s difficult to share," Orland said.

Find an opening

Thanksgiving is National Family Health History Day, but you don’t have to wait until November to talk turkey. Any time you’re gathered with relatives is a good time to get insights into your family’s health. One way to broach the subject is to say: "I have a physical coming up, and I know they’re going to ask about family history. Is there anything I should know about?"

Watch for clues

Sometimes distant family history can be murky, and older generations might use different language to describe health conditions. "Someone might say that a relative had 'women’s trouble' or 'the shakes' or 'was a recluse,' so be aware of the type of language people might use to cover all manner of health conditions," Orland said. "When you can, gently probe for more details."

Look for connections

Autoimmune diseases can run in families, but you may not realize it if your relatives have different autoimmune conditions, such as multiple sclerosis, lupus, rheumatoid arthritis and Crohn’s disease. Although there are many variables that determine the likelihood of developing an autoimmune disease, it’s helpful to your doctor to know whether you have a family history of certain conditions.

Know the red flags

Knowing the age of when first-degree relatives (siblings, parents or children) developed certain conditions is valuable information. If both parents suffered from heart disease before the age of 55, your risk can be as much as 50 percent. Similarly, if your parent experienced a stroke, especially at a younger age, you may have a slightly higher risk of stroke.

"Our bodies break down over time, and that’s why cancer in older patients is not considered to be a strong familial risk," Orland said. "But you don’t think of people getting sick in their 20s, 30s and 40s. When we see people presenting with cancer or cardiovascular disease at younger ages, that’s when you wonder if they were born with a stronger genetic predisposition to that disease development."

Also, consider the role of lifestyle. "If someone smoked like a chimney and ended up with lung cancer, that tells you that their lifestyle was probably a factor," Orland said.

Branch out

At a minimum, you want to gather information about first-degree relatives and your grandparents. Those health histories will tell you the most about your own potential health risks.

What parents of younger kids may not realize is that your child’s heart health can also reflect your own. One of the most common genetic disorders is familial cholesterolemia, which affects approximately 1 in 250 adults. Current guidelines recommend kids between ages 9 and 11 have their cholesterol checked, and if their levels are high — a total cholesterol of 300, with an LDL of 170-200 — chances are at least one of their parents has high cholesterol, too. In fact, there are adult patients in UW Health’s Preventive Cardiology Program who were diagnosed because of their child’s test results.

The health of aunts, uncles, cousins and other distant relatives can be helpful, as well. "I try to fill in the family tree with as much health information as possible," Orland said.

Write it down

You might forget the details by your next check-up, so jot down notes in your cell phone, in a notebook, or in the personal note section of your electronic health record through your health system. The Office of the U.S. Surgeon General also offers a free online tool called My Family Health Portrait, which allows you to create a printable family health history that you can update over time and also share with relatives.

Pass it on

If you’ve gone to the effort of creating a family history, share it with others, especially your kids once they’re developmentally ready. But don’t feel guilty about any “bad” genes you may have passed on to the next generation.

"Every human is a carrier for a handful of autosomal recessive conditions," Orland said. "Everything had to come from somewhere, and we can’t choose what we pass on. We have to take the good with the bad."