All in the Family

As Weglowski learned how his genes affected his health, he considered the genes he passed to his sons, who were 11 and 8.



Weglowski presents the medal he received for a marathon to his cardiologist, Dr. Amjad Farha

Greg Weglowski thought he was invincible. After all, he led an active life in law enforcement, ran marathons, sky dived and volunteered for the first Persian Gulf War. "I’ve always been a bit extreme," the Detroit native admitted. His family’s heart history was no exception. His father had triple bypass surgery and a heart valve put in at age 49. His mother underwent five bypasses by age 53.

Even though he didn’t have a healthy diet, Weglowski was in good shape and thought he was immune to getting sick. In fact, after his eighth marathon in 2007, he passed a stress test "with flying colors."

But the next year, at 40, Weglowski saw his primary care physician about shortness of breath and fatigue. Knowing his family history, his physician referred him to a cardiologist for tests. Weglowski got some bad news: He’d already had a heart attack, and several arteries were blocked: His left anterior descending artery was 100 percent blocked, his left circumflex artery 90 percent and his right coronary artery 50 percent.

Weglowski could remember the day that he probably had the heart attack. Two weeks earlier, he’d experienced shortness of breath, mild pain in one arm and fatigue. That was probably when he’d had the heart attack.

"I still went to work and had no idea what was wrong with me. I had just finished another Federal Law Enforcement Academy and was in excellent shape," he said. "I didn’t think the family history would hit me."

GENETICS 101

Weglowski’s story points to the power of genes, the units of DNA passed from parents to children. Genes provide instructions for cells to make proteins that carry out bodily functions and form physical characteristics. Just like hair color, a predisposition to certain diseases can be passed along. Knowing your family’s health history can help you avoid heart disease and stroke by knowing what symptoms to look for and what lifestyle modifications to make.

Greg Weglowski with sons Alexander (l) and Collin (r)

"Both the risk of heart disease and risk factors for heart disease are strongly linked to family history," said William Kraus, M.D., a preventive cardiologist and research scientist at Duke University "If you have a stroke in your family, you are more likely to have one."

In fact, your risk increases if your father or a brother were diagnosed with heart disease before age 55, or if your mother or a sister had heart disease before 65.

As Weglowski learned how his genes affected his health, he considered the genes he passed to his sons, who were 11 and 8. "‘Look guys, dad had a heart attack,’" Weglowski remembers telling his sons. "They saw what was going on, and it became ‘Hey, we have this running in our family. What can we do together to have a healthier lifestyle?’"

Bill Edwards, a clinical psychologist and adjunct clinical faculty at the University of Texas Southwestern Medical Center at Dallas, said that focusing on the positive is the best way to help kids younger than high school-age modify risk factors. He suggests explaining that the heart is a pump, and diet, exercise and stress affect how well it works.

"I wouldn’t focus on a bad family history unless children ask specifically, but certainly make sure they know about it before they leave home so they can make educated decisions," he said. Edwards also emphasizes the importance of modeling behavior, especially with school-age children.

"It’s clear that parents’ behavior is transmitted to kids," he said. "They won’t absolutely adopt every good habit you have, but modeling plays a significant role. With nutrition, I think it’s important simply not to have bad stuff at home."

GET YOUR FAMILY HISTORY

The American Heart Association offers a printable family tree that helps families piece together their health history. Start with your immediate family. Find out if your brothers, sisters, parents or grandparents had heart disease or stroke and how old they were when it was diagnosed. You probably don’t need to research beyond those relatives. A great-grandparent’s history is not relevant because their environment and treatment options were very different.

But the family tree isn’t fool-proof. Even if your family tree is clear of heart disease, other genetic factors, like race, can increase your family’s risk. African-Americans face higher risks for high blood pressure, diabetes and stroke. One in four Latinos will experience high blood pressure, and nearly half will battle high cholesterol.

No matter your family history, most regular cardiovascular screening tests should begin at age 20, with follow-ups depending on your level of risk. You will probably require additional and more frequent testing if you have a strong family history of heart disease or an existing heart condition.

Linda Knight, a cardiac genetic counselor with Children’s Healthcare of Atlanta, says that it is important to know the specific conditions that contributed to familial heart disease, such as high cholesterol, structural heart issues or arrhythmia. That way families can make informed decisions with their pediatricians as to the best early testing or interventions for children. "For example, if there is a family history of high cholesterol, it is appropriate to screen children by lipid profile at any age. General lipid screening is recommended at 12 years old." She adds, "If there is a family history of sudden unexplained death, arrhythmia (such as long QT), or cardiomyopathy, all first-degree relatives at any age should see a cardiologist for an echocardiogram and a genetic counselor to determine whether genetic testing would be helpful." A genetic counselor can be located on the Website for the National Society of Genetic Counselors at NSGC.org.

TURNING BAD NEWS INTO GOOD NEWS

According to research presented at the American Heart Association’s Scientific Sessions 2014, adults counseled on their genetic risk of heart disease believe they have more control over their fate. That makes them more likely to adopt behaviors that reduce risk.

But many people with a family history of heart disease become pessimistic about how much they can control their health. After all, if an active man like Weglowski had a heart attack, what hope do less active people have? To defeat that thinking, consider your health like a cup that you want to keep from overflowing. Bad genes fill part of the cup, and bad habits like smoking add to it. Because of their genes some people, like Weglowski, start with fuller cups, but good habits like walking regularly and a eating salads keep the cup from overflowing.

Weglowski’s doctor told him that if it weren’t for his active lifestyle, he may not have made it. So by modifying one behavior, Weglowski unknowingly saved his own life. Further, Weglowski had a terrible diet before the heart attack. Now he eats healthy whenever possible — yet another factor he is able to control. He admits it can be difficult to stay motivated to eat healthy. "There are days we eat the burgers and fries and pizza," he said, "but we know that in order to stay out of the doctor’s office we must stay active and eat healthy. My boys and I have no choice."

Many types of heart disease can be inherited. Some conditions like high blood pressure or coronary artery disease run in families but most likely result from multiple genes working together in a complex way to cause disease. So even if you have a strong family history, you are not guaranteed to have inherited the combination of genes that lead to cardiovascular diseases. Weglowski’s sisters, for example, have no heart issues. And your lifestyle or environment can affect whether they are "expressed" or not.

Weglowski and his sons on an Alaskan fishing trip

Edwards points out that many people with a bad family health history take the approach that there’s nothing they can do. But even if you do believe that you’re destined to die at 70 of heart disease — because your parents did — what do you want life to look like until then? Eating healthy, exercising and reducing stress all help give you the energy and stamina to make the most of your life. Making healthier choices is not only about prolonging life, it’s about living the most vibrant life you can with the people you love.

Weglowski won’t let fear of family history slow him down. Seven years after the heart attack, his family remains active and healthy.

"They’re typical teenagers now, but they do pretty well," he said. "If we go out to eat, we’re not going to a fast food place." They enjoy the gym and boating together, and they recently dove with whale sharks at the Atlanta aquarium and went fly fishing in Alaska — creating a family history that anyone would be glad to have.


 

TIPS FOR FILLING OUT YOUR FAMILY TREE

 

If your kids have an interest in family health history, put them to work at family gatherings, collecting information and stories.

  • Dig a little deeper. Some family members might be hesitant to talk about their health issues, but they might be willing to discuss their own parents’ health, which can give you some insight. You can also talk with aunts and uncles. Remind reluctant family members how their information can benefit the next generation.
  • Be an example. If family members hear you talking about your health history, they’ll be more likely to join in. Use these sharing moments as an opportunity to support each other in making healthy changes.

 

TO HELP KIDS BE ACTIVE, THINK LIKE A KID

 

Whether or not you have a family history of heart disease, getting active is important.

"Breaking the habit of inactivity is hard once it is established," said Steve Jeffries, Ph.D. and professor in the Department of Physical Education, School and Public Health at Central Washington University and president of SHAPE America (Society for Health and Physical Educators), about dealing with adolescents and teens on this issue. Being inactive increases the inclination for inactivity. "Breaking that conditioning is hard once it is established," Jeffries said. And if kids become conditioned not to be active, there are a lifetime of consequences to that.

"One of the biggest mistakes parents make is thinking of children, including teens, as miniature adults," Jeffries said. "Kids don’t have our interests in health. Research shows that they participate in activities for three reasons: to have fun, be with friends and learn skills."

The challenge for parents is to think outside their own box of activities that they enjoy. "There are many forms of dance, for instance, but if you are not a dancer, you won’t think of them," he said.

Jeffries says it is important not to limit the choices to what is easily accessible. For instance, in cities there are lots of basketball courts, so plenty of opportunity to play basketball. "But a lot of kids are not attracted to team sports," Jeffries said. "They prefer to do things where they aren’t going to be judged in public."

Here is what parents can do: 1) Be physically active yourself. 2) Look for opportunities beyond your own interests. 3) Remember, fun and camaraderie (not competition) matter most. 4) Take your cues from your children about what’s fun for them.


HELPING KIDS EAT HEALTHY

Eating a healthy diet is one way to lessen the impact of bad genes, and it certainly makes you feel better. Teaching children about healthy eating benefits them their entire life. The best way to teach good nutrition to children is to be a good role model. You can’t expect them to eat healthy if you don’t! We talked with Kristen Doenges, a registered dietitian with Professional Nutritional Therapists in Dallas, about engaging children in eating better. She advises against using food as a reward and to refrain from making them finish everything on their plate. Those habits can set them up for obesity. Instead, let ‘em help!

Bring on the breakfast parfaits. Set out berries and low-fat yogurt and granola with bowls and spoons.

Have a pizza night. Make mini-pizzas with whole grain English muffins, marinara or pizza sauce, low-fat mozzarella and raw veggies. Parents handle the oven.

Make pinwheel snacks. Spread hummus on a whole-grain tortilla, then add fresh lettuce or spinach. Roll up the tortilla and slice into pinwheels.

This information is provided as a resource to our readers. The tips, products or resources listed have not been reviewed or endorsed by the American Heart Association.

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