Heart Disease and American Men
Half of all men who die suddenly of coronary heart disease have no previous symptoms.
The Men’s Health section of our Community page will focus on the top concerns for American men and how these diseases can be identified and prevented prior to the occurrence of symptoms.
Heart disease is the #1 cause of death of American men. The term “heart disease” refers to several types of heart conditions. The most common type is coronary artery disease, which can cause a heart attack. According to the Centers for Disease Control and Prevention, high blood pressure, high cholesterol, and smoking are key risk factors for the disease. About half of Americans (47%) have at least one of these three risk factors. Other lifestyle factors that increase your risk of developing heart disease are diabetes, obesity, poor diet, physical inactivity and excessive alcohol use.
While chest pain is the commonly accepted symptom of a heart attack due to heart disease, many other symptoms can also be present:
Upper body pain or discomfort in the arms, back, neck, jaw, or upper stomach
- Shortness of breath
- Nausea, lightheadedness, or cold sweats.
The rates of occurrence and survivability make heart disease a major concern for American men and their future health.
Can heart disease be prevented?
Lifestyle factors can drastically reduce your risk of heart disease.
Maintain a healthy weight.
Eat a healthy diet.
Prevent or treat high blood pressure, high cholesterol, and diabetes.
The best prevention of heart disease is to know the status of your risk factors before symptoms occur, or worse, you experience a heart attack.
The Health Nucleus’ integrated assessment incorporates a deep dive into your heart health, including a study of electrical activity through wireless heart rhythm monitoring and an electrocardiogram, calcific plaque disease detection through coronary calcium scoring, study of the structure and function of the heart through cardiac MRI and echocardiogram.
In addition to these phenotypic (or physical) measurements, many genes contribute to an increased risk of heart disease. Our whole genome sequencing is a genomic analysis that compares your genes with others who have the disease to identify your inherited risk.
A Conversation with Dr. Robert Darling, Chief Medical Officer at Patronus Medical Group
Dr. Robert Darling is the Chief Medical Officer of Patronus Medical Group, a concierge medical practice based in Virginia. He’s also a retired Navy Captain, who was the first Board-Certified Emergency Medicine physician to serve as the White House Physician to the President of the United States, the Vice President, their families, and other senior government officials. During his Navy career, he served as Flight Surgeon aboard the aircraft carrier USS Theodore Roosevelt. His career has provided him with a unique and respected perspective on healthcare. When he reached out to us to share his personal story and insights we naturally jumped at the opportunity.
The Importance of Family Health History
Research has shown that family history is a risk factor for many diseases. Tracing the health issues that have affected your relatives can tell us what conditions you may have a higher chance to develop in your lifetime. For example, a person who has multiple family members with a condition like heart disease, diabetes or cancer is more likely to develop the condition than someone with no family history. There are multiple reasons this may be the case. People in the same family share genes, but often share environment and lifestyle factors too that contribute to the development of a condition.
What can I do?
Gather your family history! Reach out to relatives to collect information on their health and to learn about past generations. Family gatherings are a fabulous opportunity to do this. Once this information is collected, it can be saved for the benefit of generations to come.
What type of information should I collect?
- Medical conditions diagnosed in relatives
- Causes of death
- Age at diagnosis and age at death
- Ancestry and ethnic background
- Exposure history such as asbestos, and alcohol or tobacco use
How do we use family history in the Health Nucleus?
At your visit to the Health Nucleus, a clinician will ask you about your medical history and the history of your relatives, including first-degree relatives (children, parents and siblings), and second-degree relatives (grandchildren, nieces, nephews, grandparents, aunts and uncles). A three-generation family tree will be drawn. The history will be used to understand your risks and family members’ risks for various health conditions.
Our team assesses whether there is a pattern of disease that suggests a genetic condition. Even if your genetic test results show no harmful gene variant, you may benefit from increased screening. Family members may be recommended to consider genetic testing.
The National Center for Biotechnology Information, National Institutes of Health
Centers for Disease Control and Prevention, National Office of Public Health Genomics www.cdc.gov/genomics
Genetic Alliance http://www.geneticalliance.org/programs/genesinlife/fhh
U.S. Surgeon General’s Family History Initiative https://www.cdc.gov/genomics/famhistory/knowing_not_enough.htm
X-Linked Recessive Inheritance
How are genes inherited?
We have two copies of every gene in our bodies, inheriting one from our mother and one from our father. Our genes are located on chromosomes inside the nucleus of each cell. There are 23 pairs of chromosomes. The first 22 pairs are numbered and are the same in males and females. The 23rd pair are the sex chromosomes, with females having two X chromosomes and males having an X and a Y chromosome. Males pass on their X chromosome to all of their daughters and their Y chromosome to all of their sons.
X-Linked Recessive Inheritance
Many genetic diseases are caused by changes or “variants” in a single gene. A variant can cause the gene to not work properly. Whether or not people show signs of a genetic disease depends on how the disease is inherited. X-linked recessive inheritance means the disease happens when a variant occurs in a gene located on the X chromosome. Because men only have one X chromosome, they will likely show symptoms of the disease if they have an X-linked gene variant. They will pass this X chromosome on to all of their daughters, who will be “carriers” of the X-linked gene variant. However, since they only pass on their Y chromosome to their sons, none of their sons would inherit the X-linked gene variant.
Carrier females of X-linked variants are usually healthy with no related symptoms. However, some may show mild symptoms, depending on the specific disease. Each of the sons of a carrier female has a 50% chance of being affected with the disease and each of her daughters has a 50% chance of being a carrier. A female can show full symptoms of an X-linked disease if she has variants in BOTH copies of an X-linked gene.
Why is this important for you?
Knowing about carrier status of an X-linked recessive variant and potential risks of disease can be helpful in discussing family planning and reproductive testing options. Since relatives also have an increased risk of being carriers of a gene variant, this can be important information to share with your family. Many severe X-linked recessive gene variants occur for the first time in one person as a “new mutation”. In this case, there may not be a family history of a disease and screening for these gene variants can be helpful in providing more information about possible risk of a disease in a family.
Will my results from the Health Nucleus provide more information?
Through our whole genome sequence (WGS) analysis, we screen for medically significant variants in hundreds of genes, some of which follow X-linked recessive inheritance. Examples of some X-linked recessive diseases that will be screened for through your WGS, include Hemophilia A and B, along with many others. Your genomics reports will specify if you have one or two variants in an X-linked gene, depending on if you are male or female. This report will be reviewed in detail with you by one of our clinicians.
Where can I learn more?
National Society of Genetic Counselors: https://www.nsgc.org/findageneticcounselor
Genetics Home Reference: https://ghr.nlm.nih.gov/
Help Me Understand Genetics: National Library of Medicine (US). Genetics Home Reference [Internet]. Bethesda (MD): The Library; 2018 Apr 3. Inheriting Genetic Conditions; [cited 2018 Apr 3]; Available from: https://ghr.nlm.nih.gov/primer#inheritance. Accessed April, 2018.
Illustration: National Library of Medicine (US). Genetics Home Reference [Internet]. Bethesda (MD): The Library; 2018 May 22. [Illustration] X-linked recessive; [cited 2018 May 22]; Available from: https://ghr.nlm.nih.gov/primer/inheritance/inheritancepatterns.
Family Planning and DNA
How can the whole genome sequencing (WGS) I have through the Health Nucleus be helpful in family planning?
Through our WGS analysis, we screen for medically significant changes or “variants” in hundreds of genes that can be associated with genetic diseases. Your WGS results will be reviewed in detail with you by one of our clinicians. If you learn that you have a variant in a gene, questions may arise:
- What does this mean for my children and/or their future children?
- Are they also at increased risk and are there any additional tests that can be done to learn more?
Genetic diseases are unique from other medical conditions because they have the potential to affect more than one family member. Genetic diseases are also inherited in different ways, which means that the risk to future children and other family members varies. (Please see our HLI Community guides on inheritance patterns.)
Why is this important for me?
If you or a family member are considering having children, you may want to learn more about the risks and family planning options associated with genetic diseases. For couples at increased risk of having a child with a genetic disease, several reproductive tests are available to provide more information, including:
- Preimplantation genetic diagnosis (PGD): this type of gene analysis is done before pregnancy via in vitro fertilization (IVF) through a fertility specialist and/or assisted reproductive genetics center. After IVF, embryos are tested for the specific gene variant to determine if any have inherited the disorder. Embryos that don’t test positive for the genetic disorder are transferred to the uterus with the hope of leading to pregnancy.
- Prenatal diagnostic testing: analysis of the gene in question can be done through two different testing options during pregnancy:
- Chorionic villus sampling (CVS): this procedure is done in the first trimester of pregnancy and involves sampling a small piece of placenta which can then be sent to a specialty laboratory for culture and analysis of the gene variant.
- Amniocentesis: this procedure is done ideally in the second trimester of pregnancy and involves removing about 20-25 cc amniotic fluid which is then sent to a specialty laboratory for culture and analysis of the gene variant.
Treatments are available for many genetic disorders and genetic testing before birth can make a major difference in medical management and even save a child’s life. However, for other genetic diseases, treatment may not be available, and deciding whether to have any additional testing before or during pregnancy is a personal decision. Also, both of the prenatal diagnostic testing options are invasive and carry a small risk of pregnancy loss. Because of these possible risks, some couples choose to wait until after a baby is born to have diagnostic testing on blood. There is no right or wrong answer.
How can I learn more?
Meeting with a genetic counselor who focuses on reproductive and family planning issues can be helpful in discussing these options in more detail. Genetic counselors are professionals with specialized training in clinical genetics who provide education and non-directive guidance to patients and clients about their genetic health. To find a genetic counselor in your area, go to: https://www.nsgc.org/findageneticcounselor
To learn more about genetic diseases and family planning options, go to: http://aboutgeneticcounselors.com/
About Genetic Counselors. National Society of Genetic Counselors, http://aboutgeneticcounselors.com/Genetic-Conditions/Prenatal-Conditions. Accessed April, 2018.
Startup Health: Cracking the Longevity Code
J. Craig Venter, PhD, CEO of Human Longevity, Inc, sheds light on a future powered by genomics & preventative medicine.
When it comes to achieving theStartUp Health’s Longevity Moonshot, Human Longevity, Inc. (HLI), is as close as it gets to adding 50+ healthy years to every human life. Through their pioneering work, Dr. J. Craig Venter, CEO of HLI, and his entire team are redefining the way we think about preventative medicine, early disease detection, and organizing the world’s genomic data in a more efficient manner.
Gut Health Series: Formation
We’ve all been told to eat right and exercise, but the reasons to do so extend far deeper than how we fit into and feel in our clothes.
The health of your digestive tract or “gut” plays a key role is your overall health and well-being. Your gut runs from your mouth to your anus and affects every system in the body.
Around 60 to 70 million Americans are affected by digestive diseases such as gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). Many more people have other digestive problems and are affected by poor nutrient absorption and inflammation. These digestive problems are not only painful but can lead to other more serious conditions.
The Community Gastrointestinal section will be featuring a series of 6 blog posts dedicated to education on:
- How gut health is formed
- Leaky gut
- Symptoms of poor gut function
- Prebiotics and probiotics
- Gut health’s link to mental health
- Inflammation and autoimmunity
How Gut Health is Formed
Gut health starts at birth. Our first interaction with bacteria occurs in our eyes, ears, nose, and mouth through the birth canal. Therefore, our mother’s microbiome, and the environment around us play a role in our overall gut health. Our second introduction is via colostrum from the first breast milk feeding. Because we don’t have much control over how we came into this world or if we were breastfed, paying attention to lifestyle factors that contribute to poor gut health and working towards healthy gut flora across your lifetime will be extremely important for your overall health.
Factors that contribute to poor gut health
Lack of exercise/movement
Lack of diversity in the diet
Lack or prebiotics in the diet
Overconsumption of antibiotics
Alcohol and tobacco
Toxins in our physical and chemical environment
Not drinking enough water
Painkillers, NSAIDS, over the counter medications
Travel to other countries-parasites, infectious diseases
Your gastrointestinal (GI) tract is lined with microbes, which includes bacteria, fungi, and even viruses. Gut bacteria perform many important functions in the body, including immune system support, assistance with serotonin production, digestion and processing of food, and disposal of toxins and other foreign substances that come into the body.
We need a diverse balance of good bacteria, but when bad bacteria get introduced or good bacteria get out of balance, dysbiosis can occur which can lead to a host of health conditions including digestive issues, inflammation, weight fluctuation, skin conditions, mental health impairments and chronic illness. It is extremely imperative to keep your gut bacteria as friendly and abundant as possible.
The Health Nucleus features a microbiome test – an analysis of a stool sample that provides a summary of microorganisms and their genetic material that reside in the GI tract. We also provide a multi-targeted stool DNA test which is a colorectal cancer screening alternative.
With this health intelligence, certified nutritionists can provide individually-tailored guidance to help restore gut functioning through targeted nutrition, supplements and lifestyle recommendations.