Genetic risk factors for heart disease: How to determine your inherited vs. lifestyle risks

When most people think about heart health, they focus on things like diet, smoking status, and exercise. While these lifestyle choices matter a lot, there’s another powerful factor at play: your genes.

Hereditary risk factors for heart disease shouldn’t be ignored, even if you have a healthy lifestyle. The earlier you become aware of your genetic status, the sooner you can take preventive measures and make lifestyle choices to lower your risk and stay ahead of heart problems.

In this article, we’ll discuss the genetic risk factors for heart disease, the genes most commonly linked to cardiovascular conditions, and screening options to help you better understand your health outcomes.

How do genetics and family history affect the risk of heart disease?

Your genes play a big role in how your cardiovascular system functions. They influence everything from blood pressure regulation and blood vessel strength to how your heart muscles work.

Certain genes can carry pathogenic variants, disrupting the way the cardiovascular system works and increasing the risk of heart disease.

Typically, genetic risk factors for heart disease are classified into two categories:

1. Inherited risk

2. Family history risk

Check out the crucial differences between the two below:

Inherited risk is often tied to conditions like high cholesterol, heart muscle diseases, or serious heart rhythm problems. A family history risk factor implies that a relative, like a parent or cousin, was diagnosed with heart disease, usually before the age of 60.

Keep in mind that inheriting a gene variant or having a family history doesn’t automatically mean you’ll develop a cardiovascular condition. With lifestyle changes, early screenings, and even biohacking methods, you can significantly lower your risk.

Genetic heart disease risk: Differentiating between monogenic and polygenic risk scores 

Another common concept when exploring heart disease is your risk score. It estimates your likelihood of developing a cardiovascular condition based on different factors, including your genes.

Genetic heart risk is generally categorized into: 

1. Monogenic risk

2. Polygenic risk

1. Monogenic risk

Monogenic risk refers to the likelihood of a heart condition occurring based on changes in a single gene. While relatively rare, monogenic cardiovascular diseases tend to be more severe and often show up early in life.

Examples include:

• Hypertrophic cardiomyopathy

• Arrhythmogenic right ventricular cardiomyopathy

• Long QT syndrome

• Brugada syndrome

• Familial hypercholesterolemia (FH)

• Marfan syndrome

• Certain types of inherited hypertension

It’s important to understand that even if you carry a pathogenic variant for one of these conditions, it doesn’t automatically turn into the disease. Other factors, like lifestyle, environment, or even additional gene interactions, can come into play.

Still, knowing about these risks early allows for proactive care, lifestyle changes, and targeted monitoring to lower the chances of serious outcomes like sudden cardiac events.

2. Polygenic risk

Polygenic risk refers to the likelihood of developing a condition based on the combined influence of many genetic variants, often across hundreds or even thousands of genes. Each of these variants may only slightly increase your risk, but together, they can have a significant impact.

Scientists use the polygenic risk score (PRS) to understand the impact of these variants by studying genetic markers (called SNPs or single-nucleotide polymorphisms) across your DNA. These SNPs are weighed based on how strongly they’ve been associated with heart conditions in large genetic studies.

Once the markers are analyzed, your PRS estimates how your genetic risk compares to others, categorizing it as low, average, or high. PRS is especially useful for people with no evident family history of heart disease, who might still carry an elevated risk.

To get your PRS, take a comprehensive genetic screening test like Nucleus Health. It uses whole-genome sequencing to assess almost ALL your DNA, so you get a more accurate risk assessment of 130+ potential cardiovascular problems, as well as PRS values for 900+ other conditions.

Genes that increase your hereditary risk factors for heart disease 

The table below highlights genes that influence your cardiovascular health:

Note: This isn’t a complete list. Research around heart-related genes is still growing, and scientists are finding more genetic variants that might play a role in heart health.

How does family history influence heart disease risk?

Source: RDNE Stock Project

Your heart disease risk often begins with your first-degree relatives (your parents, siblings, or children). These are the people who share about 50% of your DNA, and your risk of cardiovascular disease is increased if any of them have a heart condition, especially before the age of 60.

[Reddit](https://www.reddit.com/r/HeartAttack/comments/1h089vj/comment/lzlw0pk/)(350)

Does your risk depend on which of your first-degree relatives had the condition? Research suggests it might. One study that observed over 2000 people with a family history of cardiovascular disease found that those with:

• A paternal history had a 75% increased risk of developing a heart condition 

• A maternal history had a 60% increased risk of developing a cardiovascular disease 

• A sibling who had heart disease faced a 40% higher risk

The good news is that knowing your family history can help you take the right steps to prevent severe heart problems from developing. You can’t change your DNA, but you can change your approach to your health, especially if you carry genetic risks.

It’s not only about genes. Families also tend to share habits and environments — the kinds of food they eat, how active they are, even how they handle stress. When we talk about family history, we’re talking about a mix of genetics and lifestyle.

If you’re at higher risk due to family history or inherited genes, here’s what you can do:

• Genetic screening to understand your risk

• Make heart-friendly changes to your diet

• Stay consistent with physical activity

• Reduce stress and get enough sleep

• Avoid tobacco and limit your alcohol intake

[Reddit](https://www.reddit.com/r/PeterAttia/comments/1bz0ufk/comment/kysgply/)(365)

Bonus: Learn what genetic factors increase women’s risk of cardiovascular diseases.

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How to determine your genetic risk factors for heart disease

Source: Ivan Samkov

The only way to know for sure whether you carry gene variants that raise your risk of heart disease is genetic screening. 

[Reddit](https://www.reddit.com/r/genetics/comments/14x1uaw/comment/jrl4o81/)(250)

Genetic screening involves collecting a small sample of DNA (typically through blood, saliva, or cheek swabs) and testing it for gene variants linked to heart disease.

You’ll typically have two options:

• A multi-gene panel, which looks at specific genes associated with certain conditions (like FH or cardiomyopathies)

• A whole genome sequencing (WGS) test, which scans your entire DNA to uncover both known and potentially new or overlooked variants

While multi-gene panels are useful, they’re limited to a select group of genes, which makes them incomplete. WGS casts a wider net, helping you get deeper insights into your hereditary heart disease risk.

Nucleus Health: Browse 130+ genetic insights for heart health

Nucleus Health offers a clinical-grade genetic health test that uses whole genome sequencing to give you a full picture of your heart health, with 99.9% precision.

With Nucleus, you can uncover your risk for:

• Heart conditions like familial hypercholesterolemia, stroke, and coronary artery disease

• Gene variants linked to lipid metabolism, blood pressure, and arrhythmias

• Cardiomyopathies, including hypertrophic and dilated types

In total, it tests for 130+ cardiovascular-related genetic markers and 40+ diet-related markers that influence your heart health. Beyond heart health, you’ll also get screened for hundreds of other traits and conditions related to neurological health, mental health, metabolism, energy, and more — all with a single test.

Nucleus reports are user-friendly and easy to interpret, but you can also get post-testing support to help you understand next steps. Nucleus AI gives recommendations on lifestyle and dietary changes to lower your risk.

Nucleus also partners with SteadyMD, connecting you with board-certified genetic counselors who can review your results with you and discuss proactive measures you should take to maintain and improve your cardiovascular health.

How to get started with Nucleus 

Nucleus is HIPAA-compliant and testing is done from the comfort of your home. It costs [PRICE.KIT_SOLO.ONE], which covers the at-home DNA kit, two-way shipping, and comprehensive genetic reports (you can also download your raw DNA data).

Follow these steps toward understanding your genetic health markers:

1. Sign up for Nucleus Health

2. Provide the required details

3. Order your kit 

Your results will be ready within six to eight weeks of the lab receiving your sample.

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Featured image source: Antoni Shkraba