Your risk of developing coronary artery disease is higher if you have a close relative (mother, father, brother or sister) who developed the disease before age 65. This increased risk holds true even if you have eliminated risks that weren't as well known a generation ago, such as smoking or high blood cholesterol. The greatest inherited risk of heart disease is a genetic predisposition to have dangerously high cholesterol levels, a condition known as familial hypercholesterolemia that is marked by blood cholesterol levels above 300 mg/dl. Other genetic factors passed on from parents to children may promote the development of moderately high cholesterol or triglyceride levels, low HDL cholesterol levels, high blood pressure, diabetes or obesity.
Although you can't alter your genetic background, you can do your best to control those risk factors under your control, such as high cholesterol levels, stress, smoking, obesity and a sedentary lifestyle.
Race also plays a role in the development of cardiovascular disease, mainly for high blood pressure. Compared with whites, African-Americans tend to develop high blood pressure at an earlier age. And no matter their age, the disease is more severe in African-Americans than in whites. Because high blood pressure increases the risk of other cardiovascular diseases, African-Americans are 1.8 times more likely to have a nonfatal stroke, 1.3 times more likely to have a fatal stroke, and 1.5 times more likely to die from heart disease than are whites.
Although many theories have been proposed to explain inequalities in the risk of developing and dying from heart disease, to date, researchers have had difficulty determining the exact reasons. One theory is that African-Americans may suffer from a lack of access to health care. High blood pressure may be more common in African-Americans because of racial differences in the way sodium is excreted by the body; some researchers believe that blacks retain more sodium than whites, a factor that can work to increase blood pressure.