Knowing Your Family Health History, Part 2

This is part 2 of a three-part series on the importance of understanding your family history of disease. Please see Part 1 for an FAQ on why family history information is so important and Part 3 for a discussion on how family history information can be used to improve the health of underserved minorities.

The genetic basis of many complex diseases is still not well-understood, But, even if specific genes can’t be identified, knowing your family history can still help determine if you’re at increased risk of inheriting the disease too.

Family history can help your physician decide if you need special medical care, such as:

• Aspirin for primary prevention of cardiovascular events.
• Screening for colorectal cancer.
• Behavioral counseling in primary care to promote a healthy diet, especially for people with high cholesterol and other cardiovascular and diet-related chronic disease.
• Chemoprevention/pharmaceutical intervention for breast cancer, e.g., Tamoxifen.
• Screening for abdominal aortic aneurysm using ultrasound.
• Screening for breast cancer using mammography.
• Screening for lipid disorders, e.g., LDL and HDL, in adults.
• Screening for pancreatic cancer using physical exam, ultrasonography, or blood tests.
• Newborn hearing screening.

Family history can help your physician interpret your symptoms, such as:

• Fatigue or joint pain can indicate hereditary hemochromatosis if you have a family history of diabetes or scarring of the liver.
• Nonfebrile seizure can indicate tuberous sclerosis if you have a family history of seizures, developmental delay, mental retardation, or tumors.
• Recurrent urinary tract infection (UTI) or blood in the urine can indicate autosomal-dominant polycystic kidney disease (PKD) if you have a family history of hypertension, nephrolithiasis, cerebral aneurysm, or renal failure.
• Shortness of breath can indicate hereditary hemorrhagic telangiectasia (spidery blood vessels visible on the skin) if you have a family history of nose bleeds or telangiectasias.
• Shortness of breath can also indicate heart failure if you have a family history of idiopathic pulmonary hypertension (high blood pressure of no known cause).
• Syncope (fainting or dizziness) can indicate long QT syndrome if you have a family history of syncope or sudden death.

Family history is critical in diagnosing the following diseases early enough to manage the disease aggressively and successfully:

• Deep vein thrombosis (DVT)
• Emphysema
• Glaucoma (primary open-angle)
• Pancreatitis

This information only serves to show how important family history information can be. If you suspect that you might be at greater risk of any illness because of your family history, please see your personal physician as soon as possible.

Adapted from American Family Physician, August 2005

Part 3 of the Knowing Your Family Health History series will discuss how family history information can improve medical care for underserved minority populations.