Modifiable risk factors such as quitting smoking, exercising regularly, and eating a balanced diet can certainly help protect your heart. However, when it comes to heart disease, the role of family history also deserves serious attention. In other words, are cardiovascular heart diseases (CHD) hereditary? And if so, what can be done to lower your risk?Genetics account for up to half of a person's risk for cardiovascular disease. While it is only one among many contributing factors, it can be a significant—and often early—clue to a person’s potential for heart-related issues. Having close relatives like a parent or sibling with heart disease can increase the chances of developing a heart condition. Shared environmental factors within families, such as dietary habits and levels of physical activity, also influence heart health.Learning about family history can empower individuals to take charge of their healthcare. This knowledge allows potential health concerns to be identified before a serious event occurs and helps prevent disease progression. Identifying a genetic diagnosis within the family enables both patients and healthcare providers to stay current on recommended screenings and treatments.Heart Diseases Are Often A Mix Of Genes And EnvironmentHeart disease is often a combination of genetic and environmental influences. In certain cases, a gene may be passed down from one or both parents. If a parent carries a specific heart disease gene, there is a 50 per cent chance it could be inherited. Thus, parents can offer insight into potential future risks from a genetic standpoint.Knowing family history helps clinicians assess whether a patient is at higher-than-average risk. It’s not just about anticipating what might happen—screenings and treatments based on genetic risk can offer more proactive management.Certain Heart Diseases Can Be InheritedSeveral types of heart conditions can be inherited. These include coronary heart disease (blockages in arteries supplying the heart), congenital heart disease (a defect present at birth), cardiomyopathy (abnormal heart function without obvious cause), high cholesterol (which raises plaque risk), arrhythmias (irregular heart rhythms), and dilated aorta (an enlarged major blood vessel).Although family history cannot be changed, modifiable risk factors can still be addressed. High cholesterol or blood pressure often shows up in families around the same age, but making lifestyle changes early can help. A low-fat, low-cholesterol, and low-sugar diet, along with at least 30 minutes of exercise five days a week, can help mitigate risk. Working with a cardiologist can help determine whether lifestyle changes or early medication are needed.Collecting family history includes asking relatives about medications, diagnoses of high cholesterol or blood pressure, cardiac conditions, sudden or unexplained deaths, use of pacemakers or defibrillators, and whether anyone sees a cardiologist or has had heart surgery.After gathering this information, a physician can recommend genetic testing if necessary. Certain patterns, like multiple relatives with early heart attacks or high cholesterol, may point to inherited conditions such as familial hypercholesterolemia. Even in the absence of family history, conditions like aortopathy may qualify someone for genetic testing.Genetic testing typically starts with a three-generation family history and involves either a saliva or blood sample. Results may be positive, negative, or uncertain. Even a negative result doesn’t rule out a hereditary component, so follow-ups and testing for other family members may still be recommended.Moreover, positive results may lead to cascade testing—where relatives are tested for the same condition—and can influence treatment strategies. Precision medicine and gene therapy now offer the possibility of correcting genetic defects at a molecular level, offering new hope for those at risk.