Take Back Your Power: Modifiable Risk Factors for Heart Disease

You Can’t Change Genetics, But Here's What You Can Change

By Roberta H. Anding, MS, Baylor College of Medicine and Texas Children’s Hospital
Edited by Kate Findley and proofread by Angela Shoemaker, The Great Courses Daily

What if you have a family history of diabetes or premature heart attacks? Thankfully, there’s always something you can do to take control of your health. Professor Anding explains.

Woman checking blood pressure with doctor
The genetic expression of a hereditary disease such as heart disease can result in striking differences among family members, per each person’s particular genetic makeup. Photo By Dragon Images / Shutterstock

Modifiable Risk Factors

Genetics and ethnicity are non-modifiable risk factors—things you can’t change—when it comes to heart disease, but what are the modifiable risk factors? These are things that you can change, including stopping cigarette smoking, controlling blood sugar, preventing diabetes, reducing your high blood pressure, monitoring cholesterol, being active, and eating less food.

Controlling these risk factors can help you prevent heart disease. Diabetes is considered a heart disease equivalent, which means that individuals with type 2 diabetes should be treated like they’ve already had a heart attack. 

“There is no such thing as a ‘touch of sugar’ or ‘I’ve got a little bit going on here,'” Professor Anding said. “Often, the goals for individuals who have type 2 diabetes, in terms of their blood fats, are much more aggressive.” 

Remaining Optimistic

Now, although family history is certainly something you should be aware of, it’s important to recognize that just because you have a family history of diabetes, it doesn’t mean that a diagnosis of diabetes is inevitable for you. Many well-regarded studies show that diet and exercise do influence whether or not an individual will acquire type 2 diabetes.

For example, the Diabetes Prevention Program took people who were all at high risk of developing diabetes and put them on intensive, lifestyle modification plans. The estimated disease risk reduction was about 58% of individuals who exercised, watched their calories, and lost some weight. 

According to Professor Anding, such studies demonstrate that you can always do something to modify your risk factors. Keep in mind that if you’ve got preexisting diabetes or preexisting heart disease, your physician may have to modify your exercise program based on the medications that you’re on. 

However, this is not a reason to take on a defeatist attitude and say, “Diabetes runs in my family; there’s nothing I can do.” There’s always something you can do.

Genetic Expression

One frequently asked question that Professor Anding often gets is, “My sister doesn’t watch her weight and gets very little exercise, yet I’m the one with heart disease. How come?” 

We all know people who can eat whatever they want and others who monitor their diet carefully and still end up with high cholesterol or other health issues. This paradox illustrates the concept of genetic expression, which describes how a person’s particular genetic makeup manifests in the physical world, which can result in strikingly different characteristics even among family members.

“In my particular family, when we talk about genetic expression, I’m five foot four inches and my two sisters are five-nine,” Professor Anding said. “I got the short genes; they got the tall genes.”

The same kind of process can happen when it comes to genetic expression. 

“In my three children, two of them have high cholesterol, and the two out of three that have high cholesterol are the two that are very athletic,” Professor Anding said. “My older son’s cholesterol is perfectly okay, even though he’s a little heavier than his siblings, and he eats a whole lot of red meat. Unfortunately, we don’t get to pick our parents, and we can’t predict what kind of genes are going to be expressed.”

On a positive note, regardless of your family history or genetic expression, you can always make a difference with exercise, diet, and lifestyle modifications. That said, if you do have a preexisting condition, you should speak to your physician about tailoring your diet and exercise plan to your condition to ensure both safety and effectiveness. 

This article was edited by Kate Findley, Writer for The Great Courses Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for The Great Courses Daily.

Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.

About Kate Findley 441 Articles
Kate is a writer, novelist, and blogger living in Los Angeles. She has been writing for The Great Courses since 2017. It incorporates her two favorite things: writing and learning.