Make sure your family is heart-healthy
Q: Heart troubles seem to run in my family, so I worry about having a heart attack while I exercise and about my 35-year-old son’s risks and how to help protect him. Any suggestions? — Drew R., Santa Barbara, Calif.
A: It’s true that the risk for cardiovascular disease can be genetically passed down in some families — chronic high cholesterol or cardiomyopathy (there are two kinds, one that causes the heart wall to thicken, the other causes it to become thin and weak), for example. If those conditions appeared in your parents, their close relatives or your siblings, you should be screened and so should your son. Fortunately, there are steps to take, such as improved lifestyle habits and medications and/or surgical procedures, that can reduce — even eliminate — the risks associated with genetic predispositions to these conditions.
However, families may see heart disease in multiple generations because of a family history of habits and conditions such as sedentary behavior, being overweight/obesity, smoking, excessive drinking and not managing chronic stress responses.
As for your worry about the risk of a sudden heart attack when you exercise, a recent study that looked at records of 4,078 sudden cardiac arrest cases in people 65 and older found that just 1.9 percent happened during or following an activity.
Q: I am confused. Suddenly the MRNA booster vaccine is being criticized by the very people — you included — who heralded its arrival. What are the objections or problems and who should or should not get it? — Steven H., New York City
A: I want to stress that receiving the basic vaccine and the first two monovalent boosters is absolutely the right thing to do to protect yourself and others.
It seems that if you get the initial vaccine and boosters and then add on the bivalent MRNA booster there is a risk that your immune system will get triggered to ignore the pathogen (SARSCOV-2) instead of react to it.
Dr. Paul Offit of the Vaccine Education Center at Children’s Hospital of Philadelphia wrote in the New England Journal of Medicine that bivalent booster dosing “is probably best reserved for the people most likely to need protection against severe disease — specifically, older adults, people with multiple coexisting conditions that put them at high risk for serious illness, and those who are immunocompromised.”