Inheritance and the Seven Most Important Numbers

From Menletter March 2007

By Tim Baehr

I heard recently about a man who had a heart attack in his early thirties. Two or three arteries to the heart were almost entirely blocked. The good news is that he survived. The bad news is that he might have had a chance to prevent it.

This is a man who is, as I understand it, in otherwise good health - not obese, not abusing his body. Two things contributed to his early heart attack: The all-too-common tendency, especially among men, to avoid regular doctors' visits as long as they're feeling healthy; and ignorance of serious heart disease in his family.

Carl (not his real name) was raised by his mother; his father had left and had started a new family when Carl was very young. Contact between Carl and his father was almost nonexistent. So Carl didn't know that his father had had a major stroke at the age of 40, and that another son (Carl's half-brother) also suffered from cardiovascular disease.

Carl's cholesterol (you can bet the doctors checked it in the hospital) was what some doctors would call "incompatible with life." Because he hadn't seen a doctor in so long, he had no idea that it was so bad.

Lessons Learned

What can the rest of us learn about this near-death experience?

Let's say you're young enough that your parents are still alive. Some families don't talk about health issues, and parents seem especially prone to not telling their kids about illnesses. (I'll never know, for instance, if my prostate cancer was inherited. I know my dad had some kind of prostate surgery, but he never said what kind. I also know that he had a nonfatal heart attack at 62 - that was harder to miss - and I have made changes in my life to reduce the risk factors.) So, one thing you want to do while your parents are alive is to ask them about any cancer, heart disease, or other condition (like high cholesterol or high blood pressure) that you might have inherited. This may be very hard if your parents just don't want to talk about their health, and harder still if either parent is out of your life or otherwise estranged.

Let's say you're a bit older and have children. For their sake, tell them about any condition you or others in your generation may have that could affect your kids' health. You should also tell your siblings. If one brother gets prostate cancer, for instance, his brothers have triple the chance of getting it too. If you're estranged from any of your children or siblings, this disclosure could be difficult. How much more difficult will it be to have contributed by your silence to a needless illness or early death?

We might not enjoy this experience, either as the giver or receiver of information. There are some things we may not want to reveal, or may not want to know. Denial ("It's not important") is a powerful tool to keep us from dealing with unpleasant realities. We need to do it - tell or ask - anyway. We could save a life, maybe our own.

It Runs in the Family

What sorts of things may be inherited, or at least "run in the family"? The big categories are heart disease (or its risk factors), cancer, diabetes, substance abuse, and mental illness. Some of these can be quite self-evident in a family; others can be hidden for years and literally carried to the grave. If you are subject to any of these, it may be an excellent idea to think backward and forward one generation and see if you can be the one to break the chain - if not of the maladies themselves, then of the consequences of denial, silence, and late diagnosis.

There are some special circumstances that may make communication seem all but impossible. You may be adopted. Your adoptive parents or the adopting agency may have access to medical information about your birth parents, even if they remain anonymous or if you have no interest in looking them up. If you gave someone up for adoption or fathered a child you didn't raise, you may be able to pass on information anonymously if you discover you have an inherited condition. It's always worth asking.

If you were an orphan, or have no way of knowing your medical heritage, you can still take steps to stay healthy regardless of your unknown past. Read on.

Seven Numbers That Can Save Your Life

The other thing that contributed to Carl's heart attack was ignorance of his own health. Yes, there may be men who die at the age of 102, never having seen a doctor. There are also a few people who win the lottery. Then there's the rest of us. Many of us men take better care of our tools or our cars than we do of our bodies. Something to think about.

Here are seven numbers. Some may come up as part of a routine physical exam. Some we can figure out for ourselves. They're not the only ones, but they seem to be the ones that can predict how long you'll live, and how well you'll live while living long. Since I don't want it to seem like I'm practicing medicine, I'll leave the specific healthy ranges of the numbers - and what to do about troublesome numbers - up to a discussion between you and your doctor.

1. Cholesterol - actually a collection of several numbers including LDL, HDL, and the ratio between them. High cholesterol can lead to early heart disease.

2. Blood pressure. High blood pressure can lead to strokes, kidney failure, and other unpleasant things.

3. CRP, or C-reactive protein. This is a general indicator of inflammation; in certain ranges, it can indicate underlying heart disease.

4. Blood sugar. This is an indicator of diabetes, either inherited or caused by diet and overweight.

5. PSA - The standard test for prostate-specific antigens indicating prostate cancer (you have a one-in-six chance of getting it). In addition to the actual number, look for a rapid rise from year to year.

6. BMI, or body-mass index. This indicates if you're too fat, or even obese. You can figure this one out for yourself. Here's a calculator from the US National Institutes of health: http://www.nhlbisupport.com/bmi/

7. Waist-to-hip ratio. If you have a gut (waist as big or bigger than your hips), your internal organs are fighting a losing battle against belly fat (implicated in heart disease, among other things). Get out a tape measure.

These numbers don't tell the whole story, of course - your doctor will be analyzing lots of other numbers and recording other things he or she may see and hear. What all this boils down to - in numbers, your doctor's observations, and your family history - is information that can save your life. Once you have the numbers, it's up to you to do something about them.

Ignorance may be bliss, but the bliss may be short-lived. Let's aim for long-lived bliss: Let's inform ourselves, and our families.