Who are the skeletons in your closet?

By Jo Helen Cloys, RN, MA Ed.

You’re quite certain that your grandmother who was a concert pianist did not share any of her musical talents with you.  But she may have passed along a vulnerability to high blood pressure.

When charting your genealogy, it’s important to look not only for the prominent, talented and well-placed among your ancestors but also the skeletons-the relatives who died early because of heart disease, diabetes or breast cancer.

Most health problems are inherited to some extent, and many have strong genetic components.  These include breast cancer, diabetes, cardiovascular disease, obesity, ovarian cancer, high blood pressure, melanoma, asthma, Alzheimer’s disease and manic depression.

Located within the nucleus of each cell of your body, genes contain coded information that determines physical characteristics such as hair color, height and complexion.  Half of your genes come from your father and half from your mother.

Your inherited traits, such as fair skin or slight build, can put you at higher risk of certain disorders such as melanoma or osteoporosis, depending on your lifestyle.  In addition, genes often have built-in defects that can be passed along from generation to generation.

Scientists have learned a great deal in recent years about genes and how they influence health, but they still have much to learn.  No one can say for sure whether you will get heart disease or cancer, but a good family medical history can tell you a great deal about your special vulnerabilities.  Knowing your risks, your doctor may want to use certain screening tests more frequently than usual and give you information that may help you prevent or delay the onset of disease.

Build a Family Medical Tree

One good way to get a picture of your health risks is to chart a family tree, similar to the ones used by genealogists.  Start with yourself and branch out as far as you can.

The most important information will come from your immediate family-your parents, brothers and sisters.  Each of these “first degree relatives” shares at least some genes with you.  When you have information from grandparents, aunts, uncles, cousins, and other relatives, however, you’re more likely to be able to detect meaningful patterns.

Gathering information may not be easy.  Your sister may not tell you that she has hypertension unless you ask her.  If she has alcoholism or depression, she may not tell you even if you do ask.  On the other hand, your great aunt the doctor shopper may not have any of the problems she claims to have….but does suffer from generalized anxiety.

For relatives with whom you have little personal contact, you may have to make phone calls or write letters.  You could even try a questionnaire like the ones doctors use, with a stamped self-addressed envelope to make it easier to reply.

            As with other genealogical information, medical history often requires detective work.  A family Bible may give age of death and cause for a number of relatives.  Old photographs can indicate relatives who were obese or overweight and others who walked with canes, as a result of arthritis or a stroke perhaps.  Aunt Emma with the stooped shoulders probably suffered from osteoporosis, even though the condition was not diagnosed at the time.

Each piece of information should be added to your family tree.  Make a code for medical conditions (“cv” for cardiovascular disease, “d” for diabetes, “o” for obesity, for example) and assign appropriate codes to each person on the family tree.  Any problem that occurred at a relatively early age, such as a heart attack before age 50, deserves special note.  For deceased relatives, note the age and cause of death as well as any chronic medical conditions.

How To Use the Information you learn

Frequent notations of heart disease and stroke are to be expected; together, they account for roughly half of all deaths in this country.  Every American has good reason to take preventive measures:  exercising regularly, reducing dietary fat and keeping weight and blood pressure under control.  If you have a first degree relative who had a premature heart attack (before age 55 for men, before age 65 for women), then you have an even greater risk and should talk to your doctor about preventive strategies.

If hypertension is common among your relatives, you should act early.  Diet, exercise and weight control have an important influence on blood pressure.  When these measures fail, your doctor can prescribe a medication that will control your blood pressure and thereby decrease the risk of a stroke, heart attack or kidney failure.

Adult-onset or type II diabetes tends to run in families, but what you inherit is an increased susceptibility rather than the disease itself.  Swearing off desserts won’t protect you, but keeping your weight under control will.  According to one study, weight gain of 11 to 18 pounds doubled a person’s risk of developing type II diabetes.

Recent research also indicates that exercise may help prevent or delay the onset of diabetes.  In one four-year study men with a family history of diabetes lowered their risk 64 percent by engaging in only 40 minutes a week of moderately intense exercise such as brisk walking, jogging or slow swimming.

A family history of prostate or breast cancer is cause for concern but not panic.  Your doctor will probably recommend frequent screening tests such as mammography or the PSA blood test so that if cancer develops, it can be detected at an early treatable stage.

A decision many American women face at the time of menopause, whether or not to take hormone replacement therapy, can be made easier with information gained from a family medical history.  Estrogen not only relieves many of the symptoms of menopause but protects against osteoporosis .  On the other hand, it may increase the risk of breast cancer.  If breast cancer appears frequently on your family medical history, you and your doctor may want to look for other ways of protecting yourself from weak bones.

History is not destiny, but it can help us as we plan for the future.  A good family medical history can offer valuable insights about our health risks, allowing us to do what we can to avoid the mistakes of our ancestors.

Jo Helen Cloys is director of community relations at Pattie A. Clay Regional Medical Center.  She is a registered nurse with a masters degree in education with an emphasis in allied health. She can be reached at 859 625-3446 or by e-mail.

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