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 your family eating patterns probably include a lot of saturated fats and not as many fruits and vegetables. If your doctor knows your family medical history, she can ask you appropriate questions about your lifestyle and help you make changes that will lower your risk.
In addition, 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. You probably know little about the health history of your uncles, aunts or grandparents, and even your siblings and parents may have health issues that, for one reason or another, they haven’t shared with you.
Facts or Folklore?
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 you know, including age and cause of death for each family member. 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.
Adult-onset diabetes often goes undetected for years. In the meantime, abnormally high blood sugar levels can damage the eyes, kidneys and heart, eventually leading to life-threatening complications. If your mother was diagnosed with diabetes in her 60s, you have a higher than average risk; if your mother and perhaps other close relatives were diagnosed in their 40s and 50s, your risk is even higher. You should keep yourself healthy by exercising regularly, eating a balanced diet and maintaining normal weight.
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 exercise plus at least five servings a day of both fruits and vegetables.
Other disorders that tend to run in families include: ADHD, alcoholism, arthritis, allergies, asthma, bipolar depression, many cancers, depression, diabetes, glaucoma, hearing loss, learning disabilities, high cholesterol, miscarriages or toxemia, osteoporosis, aneurysms and vision problems.
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.
If you’re worried about privacy (and you should be whenever you give out any information online), you should know that none of the information you put on the form is stored by the government. You can save it to your computer or print it out to give to family members and your physician. If you send the information to anyone by email, your privacy is not protected unless you encrypt the message first.
REFERENCES:
“Acting Surgeon General encourages Americans to know their health history during fourth annual Family History Day,” SurgeonGeneral.gov/news, Press Release, November 20, 2007.
American Medical Association, “Family medical history.”
Pam Gaulin, “Track family medical history with a family tree,” Yahoo Contributor Network
Mayo Clinic Staff, “Medical history: comparing your medical family tree,” MayoClinic.com, November 8, 2011.
“Learn more about My Family Health Portrait,” hhs.gov.
“Surgeon General’s Family Health History Initiative,” hhs.gov.
Trisha Torrey, “Recording your family medical history–an important medical record,” About.com Guide, updated March 20, 2009.
U.S. Public Health Service, “Do you know Maria?” “Do you know Tony?” “Do you know Vanessa?” “Do you know Jim?” “Do you know Tracy and David?”
“Why is it important to know my family medical history?” Genetics Home Reference, May 20, 2013.
07/18/2013
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