Just as no two people share the same fingerprint, no two have the same risk of cardiovascular disease. Researchers at OHSU have shown that much of this risk is established well before you are born, through genetics, the health of your mother and even the way that you developed in the womb.
To encourage patients to share their family heart health history, and to help unearth risks based on the latest preventive and pregnancy cardiovascular research, experts at the OHSU Knight Cardiovascular Institute have devised a unique way to assess heart risk that incorporates questions not commonly asked by cardiologists, including:
- Birth weight
- Height of your mother
- Gender
- Whether you have experienced conditions like preeclampsia or gestational diabetes during a pregnancy
Co-led by Sergio Fazio, M.D., director of the Center for Preventive Cardiology, and Kent Thornburg, Ph.D., director of the Center for Developmental Health, a team of experts developed an online tool that can assess the user’s risk of cardiovascular disease based on lifestyle, personal health history and family health history. The result is OHSU’s Healthy Heart Family Tree, a personal heart health assessment based on a patient’s family tree.
An OHSU Knight Cardiovascular Institute research group called the Center for Developmental Health comprises more than 60 scientists conducting research in the growing field of developmental origins of health and disease, or DOHaD. The scientific foundation of the center is the 1989 Barker finding that birth weight is a crude marker for risk of death from ischemic heart disease. Today the group is exploring ways to prevent chronic illness like heart disease, type 2 diabetes and obesity.
According to Barker, smaller full-term babies, those weighing 5 pounds or less have a three to five times higher risk of dying from heart disease as an adult than those born at eight to nine pounds. Risk begins to increase again in larger birth weight babies, those born at 10 pounds and above. Placental size, shape and function, as well as the mothers’ body type, also indicate how a baby grew in the womb, and therefore play a role in the development of adult onset heart disease as well.
“While we have made incredible strides in treating heart disease so that fewer people die from it, we have done a poor job at preventing heart disease,” said Kent Thornburg, Ph.D., director of the Center for Developmental Health, OHSU Knight Cardiovascular Institute. “The field of developmental origins shows us that to reduce rates of heart disease, we must focus on prevention much earlier than we once thought.”
According to the American Heart Association, there are over 15,000 deaths due to heart disease annually in the U.S. in young women younger than 55. One reason for this is conditions that can develop during pregnancy. Major changes happen to the body during pregnancy, and the heart and vascular system must adapt. Research shows that some conditions that may develop during pregnancy can signal future heart risk, such as gestational hypertension, gestational diabetes and preeclampsia.
Experts at OHSU hope the Healthy Heart Family Tree will prompt a more detailed discussion among patients and cardiologists about their family history, which would inform the most effective preventive and therapeutic strategies.
As families gather around the dinner table for the Thanksgiving holiday, giving thanks for good health, comparing notes around personal heart health and the family’s collective heart history may go a long way toward ensuring many heart-healthy years to come.
The heart health assessment is available at www.ohsuheart.com/familytree