If you’ve ever tried to track your ancestors, you know that family history is a complex puzzle with many missing pieces. Constructing your family medical history is an even more complex process, but if you persevere and do it right, you can gain important information that can affect your own health and longevity.
Many common diseases and chronic medical conditions such as hypertension, heart disease and diabetes are said to “run in families.” That does not mean that they are directly inherited, because families share many things — environment, lifestyle, traditional ways of cooking and behavior as well as genes.
If your father, grandmother and two of your siblings died of a heart attack, you too have an elevated risk — in part because you have inherited certain genes, but also because of your family eating patterns and exercise behavior.
There are rarer conditions such as cystic fibrosis, sickle cell anemia, hemophilia and certain types of breast cancer that have a strong genetic component. Knowing that you have a family history of one of these disorders might lead you to avoid certain activities, or to be screened more frequently or at an earlier age than individuals without this genetic risk.
Your doctor can be helped a great deal by specific, scientifically accurate information, spanning at least three generations. It’s unlikely that you or anyone in your family has that kind of information.
What you do know could be inaccurate or incomplete. You may have heard that your grandmother died of “heart trouble.” But precisely what was the problem — atherosclerosis, high blood pressure, congestive heart failure, atrial fibrillation?
The U.S. Surgeon General’s Family History Initiative encourages all American families to learn more about their health history. And a web-based tool has been developed to aid the process (My Family Health Portrait: familyhistory.hhs.gov.) Since 2004, Thanksgiving Day has been designated as official Family History Day, a time to sit down with members of your extended family and share information. With the holiday a few months away, you have time to do some serious planning.
The first step could be to go online and print out copies of the HHS Family Health Portrait or the AMA’s Family History Form. These forms ask for information about your own children and about your parents, siblings, grandparents, uncles and aunts — at least three generations. Fill in all the information that’s in your memory, then pass these forms around at the next family gathering for corrections and additions.
The cause of death may not be available or may not be as relevant as it seems. Your sister died in her sleep at age 78; was it a heart attack, stroke or some other medical problem? Your father’s official cause of death was “uremic poisoning” — kidney breakdown following a bout of the flu. Just two weeks before, though, he suffered a change of personality and physical function that his doctor thought could have been due to a mini-stroke.
More important than actual cause, at least in some cases, is the age of death. Death before age 60, whatever the cause, is ordinarily a sign of medical problems that could be considered genetic risks.
It’s important to make note of persons with high blood pressure, heart disease, diabetes, cancer and stroke. These are the major killers of Americans. Again, an early age at the time of diagnosis is important information for your family health history.
A diagnosis of breast or ovarian cancer at age 40 or 50 could be a sign of hereditary breast and ovarian cancer syndrome — a change in the BRCA1 gene which affects about 1 of 800 Americans.
About three to five percent of all cases of colorectal cancer are caused by hereditary non-polyposis colorectal cancer syndrome (HNPCC), also known as Lynch syndrome. If you and your doctor know your family history, you can take early action against these genetic risks.
Even high blood pressure, which affects nearly half the population, has a hereditary component. When it develops relatively early — in the 40s or 50s — it usually involves sensitivity to salt. This can be easily corrected through a low-sodium diet and diuretic medication.
Of course, you are never doomed to get any disease because of your family history; and, conversely, you are not home free just because your relatives were healthy. Having a relatively complete and accurate Family Health History, however, makes it easier for you and your physician to determine your best strategies for staying healthy.
Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.