Following Your Heart… History
By Michelle Palmer Jones
Eighteen months post heart transplant, Rick Haas is doing well. When his granddaughters Brooklyn, Peyton, Sloane, Lucy and Shae are old enough, the family plans on talking to them about heart disease so they can take the proper preventive steps as young adults.
It wasn’t until Jeff Scheer turned 15 that he found out heart disease ran in his family. He was just a young teen back in the late 1950s, but it likely would have taken much longer for him to know about his genetics had it not been for the massive heart attack his father suffered at the age of 45. Luckily, Scheer’s father survived, and his family started making some life changes. “From that point on, we started becoming very concerned about not using butter and watching what you ate in terms of cholesterol, so I became very aware of that,” Scheer says.
A Journey of His Own
Fast forward 15 years, and Scheer thought it was time to start monitoring his heart health.
“I said, ‘I think I should have my cholesterol measured.’ I’m only 30, I’m sure everything is fine, but I do have this family history,” Scheer says. “Turns out, it was extremely high.”
For about 20 years, Scheer focused on a healthy diet and exercise as much as he could to lower his cholesterol without medication. By the time he was in his mid-50s and his cholesterol wasn’t coming down on its own, Scheer’s doctor told him a statin was the best course of action. A few years later with just a couple of months to go before he was set to retire, Scheer had a mild heart attack.
“Of course, it shakes you up,” Scheer says. “I’m aware with my family history that if I have one of these incidents, I could have another.”
Since the heart attack, he’s had a stent placed in his carotid artery, quadruple bypass surgery and a valve replacement.
“Men in my family don’t last too long,” Scheer says. “Many of them died in their 50s and 60s, most of them from heart disease. With that type of record and having my heart incident in my late 50s, I didn’t see 80 in my future.”
A Family Focused on Heart Health
Scheer will celebrate his 80th birthday in September, with his children and grand- children joining him in the festivities. They’re all very much aware of the heart journey the family patriarch has been through, and the next generations have recently begun digging into their own heart health.
“I was more concerned about my son, but it turns out my daughter recently told me her cholesterol level was high and was prescribed a statin,” Scheer says. “She has two sons in their 20s. The 24-year-old [Gabe, pictured left] in the last year told me he has high cholesterol.”
Scheer says his father never sat him down to talk about the family history of heart disease, but communication is one of Jeff Scheer’s strong suits. He has taken a different path with his family.
“I have certainly made my son and daughter much more aware of it,” Scheer says. “My grandson [Gabe] is very well educated, and he’s concerned, but he does have youth on his side. Most people don’t have heart issues in their 20s and 30s, but you get into your 40s and the risk starts getting much more significant.”
A Common Theme
Meghan Haas is a pediatric nurse practitioner who decided to go into the med- ical field after seeing both her parents experience health issues when she was young. When her dad had a mini stroke that resulted in triple bypass surgery, he wasn’t aware that he had heart disease.
“My Dad was diagnosed with heart disease at a young age,” Haas says. “I was a teenager and found out when he needed surgery. The conversation was scary because he was sick very quickly, requiring lots of interventions.”
Haas saw her father embark on a long heart journey filled with constant medications and doctor visits. He was eventually diagnosed with congestive heart failure (CHF), which was managed for a while with long-term IV medication and an artificial balloon pump. He was listed for a heart transplant in August 2020 and received a new heart in February 2021.
“Knowing my dad’s history, it is important [for me] to stay on top of routine checkups with a PCP and screenings, including cholesterol, weight and BMI,” Haas says. “Lifestyle changes for nutrition and exercise are the main preventative strategies.”
Haas’ father is doing well now, 18 months post heart transplant. Haas says she plans to talk to her five nieces about the family history of heart disease when they’re old enough to understand.
The House, the Electricity and the Plumbing
When Jeff Scheer’s father had a heart attack and Meghan Haas’ father had a mini stroke, it triggered the beginning of a heart health journey for their subsequent generations. Not all families experience an event that is the catalyst for change. For many, their history is either unknown, or it takes a very proactive conversation to figure it out.
Dr. Joyce Williams, an internal medicine specialist at TriStar Centennial Medical Center in Nashville, Tennessee, says there are some heart conditions that carry a genetic predisposition, so healthy people can be at high risk. [For more on some inherited conditions, see page 8.]
“Knowing your risk factors might be the motivation you need to change your lifestyle,” she says. “Stop smoking, lose weight, exercise more and eat better.”
Your doctor may also choose to avoid certain medications or recommend particular interventions if he or she is aware of a specific family history. “This allows for the possibility of promoting prevention, performing screening tests and conducting more frequent follow-up as necessary,” Dr. Williams explains.
So how do you get the conversation started, and what do you ask? Dr. Williams says having an awareness of your family medical history is a lot like doing a family tree. “Start with siblings, then parents, parents’ siblings and then grandparents,” she says. “Only blood relatives are pertinent.”
To begin, she recommends asking more general questions about a history of cardiovascular disease and related conditions such as hypertension, hyperlipidemia and diabetes. Then you can dive deeper.
“Since there are a few different types of heart disease you can have, it’s prob- ably easiest to think of the heart like a house with electricity and plumbing,” Dr. Williams says.
The House (the Heart)
When making the analogy that the heart is like a house, think about what makes a house strong. It’s the structure, the foundation. Same with the heart.
“Ask if anyone in the family has died from a sudden cardiac death at a young age,” Dr. Williams says. “This might indicate history of an enlarged heart.”
The Electricity
Just as a house’s electrical system keeps the lights on, a healthy heart’s electrical system keeps it beating at a steady rate.
“Has anyone in the family had a history of arrhythmias or an irregular heartbeat? This might reveal a predisposition to things like atrial fibrillation, Wolff-Parkinson-White syndrome or Brugada syndrome,” Dr. Williams says.
The Plumbing
If a house has leaky or clogged pipes, the water can’t properly circulate. If blood vessels connecting the heart to the rest of the body are clogged or if the heart valves don’t close properly, then the heart has to work harder to keep the blood pumping.
“Ask if anyone in the family has had a heart attack, needed stents in their heart or underwent cardiac bypass surgery. Has anyone had problems with the valves of their heart? This might reveal a predisposition to coronary artery disease or mitral or aortic valve problems,” she says.
Start the Conversation About Family History Today
Often, people don’t get overly concerned about their health until they hit middle age. But new research from Ohio State University published in the American Journal of Epidemiology finds Gen Xers and millennials are experiencing worse physical and mental health than prior generations at the same age.
In fact, the researchers note that there are higher rates of depression, anxiety, smoking and obesity in those born between 1981 and 1999 when compared to older generations. This has led to a prevalence of high cholesterol, elevated blood pressure and excess belly fat in study participants, suggesting that there is potentially a higher rate of chronic inflammation.
When you take all of these risk factors and add them to a family history of heart disease, it becomes even more critical to have conversations about the role genet- ics may be playing in your health.
The takeaway: Don’t wait to talk about it. And once you know your family history, Dr. Williams says to share it. Tell everyone in your medical community and speak with other family members so they’re aware of what each family member brings to the table.
“Your primary care provider should know. If you get admitted to the hospital, your medical team should know,” Dr. Williams says. “You never know who’s going to be a patient, so having family members who know each other helps and empowers one to make decisions.”
