Ask the Doctor: Family Heart Disease History; Swollen Feet
Q: Why do doctors ask about family history of heart disease?
A: Your family health history may be a good indicator of your own health risk factors. Many diseases, including heart disease, can be referred to as “running in a family” if more than one person in the family has the condition. Some disorders are caused by gene mutations, which can be inherited (passed down from parent to child). Other conditions that appear to run in families are not caused by mutations in single genes. Instead, environmental factors such as dietary habits or a combination of genetic and environmental factors are responsible for these disorders. The more specific you can be about family medical history, the better. For example, knowing if a parent had a heart attack or stroke and at what age is useful because that signals that you, too, may be at greater risk at a similar age. It’s important to note is if the disease occurred in more than one close relative (e.g., grandparent, aunt, uncle, parents) as well as noting certain combinations of diseases that occurred within your family (e.g., breast and ovarian cancer, or heart disease and diabetes). Of course, just because a family member had a specific medical condition does not automatically mean you will develop that condition. Conversely a person with no family history of a disease does not eliminate the risk of developing it. Nonetheless, historical knowledge is powerful. For example, when there’s a family history of heart disease, health-care providers may encourage more frequent checkups, focus on particular tests and more strongly advocate for heart-healthy lifestyles. The easiest way to get and share information about family medical history is to talk to relatives. Have they had any medical problems, and when did they occur? A family gathering (even virtually) could be a good time to discuss these issues. People with a family history of a disease may have the most to gain from lifestyle changes and screening tests, as do their close family members. You cannot change your genes, but you can change unhealthy behaviors such as smoking, inactivity, and poor eating habits. Doing so may reduce your risk for diseases that run in your family
Q: My feet often appear swollen at the end of the day. What might be causing this?
A: Painless swelling that occurs in both feet and ankles is what doctors call peripheral edema. It happens when the tiniest blood vessels in your legs, your capillaries, leak fluid into your tissues and the fluid pools down in your feet and ankles. Another name for this edema is simply fluid retention. It is common to have more edema in hot weather or after a long trip. Also know that some medications may cause edema, including diuretics taken for blood pressure control, nonsteroidal anti-inflammatory drugs (like Advil and Motrin), and steroids. In most cases, it’s not dangerous and you can treat it on your own. For example, cut down on salty foods, be sure to drink about 10 glasses of water to get fluids moving out of your system, and avoid long periods of standing/sitting by walking around and stretching your leg periodically. When you are seated, prop your legs up. Compression stockings can also be helpful. Put them on first thing in the morning and wear as long as you can tolerate. They come in light, medium, and heavy compression. Try a light pair first to get used to the feeling. Another way to reduce swelling and pain is by adding 200 to 400 milligrams of magnesium to your daily diet. But talk to your doctor before taking the supplement because it should not be taken if you have a kidney or heart condition. Although less common, there are some causes of fluid retention and swelling that can be quite serious. They include heart disease and heart failure, kidney and liver disease, a blood clot that forms in your leg (thrombophlebitis), and malfunctioning leg veins that are unable to return blood to your heart (a condition called venous insufficiency). However, some fluid retention that seeps down into your feet and ankles is common and not serious. In most cases, this type of swelling goes away as soon as you prop your legs up. But if you have swelling that is frequent, painful, severe, or does not go away with home care, see your doctor.
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