I Have Hereditary Heart Disease. Here’s What I Wish I’d Known at 30

My mom was sitting in a chair, talking to my grandma on the phone, when she had her first heart attack. She was 48. She did not survive it.

I was 30. That phone call changed the entire direction of my life, and years later led me to a diagnosis I never expected: hereditary heart disease.

For years I thought that story belonged to her. It took me a while to realize it belongs to me too.

My Hereditary Heart Disease Story

I eat clean. I move my body every day. I have spent 25 years helping women do the same. And I still carry hereditary heart disease, an elevated Lp(a), higher cholesterol despite my lifestyle, and calcium already showing up in my arteries, including my carotid, the artery in my neck.

Doing everything right is wonderful and worth every bit of effort. It may not tell the whole story if the risk runs in your family. I found this out through tests most women never hear about, not because anything was wrong, but because I finally asked the right questions.

A little bit of the science, made simple

My cardiologist explained something to me in a way I have never forgotten.

Regular LDL cholesterol is one particle. Lp(a) is that same particle with an extra protein attached to the outside, and that protein is sticky. It makes the particle more likely to stick to artery walls and accumulate into plaque over time. It is simply how the biology works.

Here is the part I found most helpful. Statins, the most common cholesterol medication, do not lower Lp(a) itself. What they do beautifully is stabilize the plaque that is already there, thickening its protective covering so it is far less likely to rupture. That is important work. It just means a woman can have a lovely-looking cholesterol panel on a statin and still have Lp(a) quietly present underneath it.

The one gap almost nobody tells you about

Many doctors use something called an ASCVD risk score to decide how concerned to be about your heart. It takes your total cholesterol, HDL, blood pressure, age, and a few other factors and turns it into a single percentage, your estimated risk over the next ten years.

Here is the gap. That calculator does not include Lp(a) at all. A woman can run through it, land in the low-risk category, and still be carrying significantly elevated Lp(a) that the standard formula never even asked about. That is not a flaw in you, nor in your doctor. It is a blind spot in the tool itself, and it is exactly why asking for the right labs by name matters so much.

Tests worth asking your doctor about

If you have a family history of heart disease, especially a parent or sibling with an early heart attack or stroke, here are a few things worth requesting by name at your next visit.

• Lp(a). Usually a once-in-a-lifetime test, since it is genetic and does not shift much with lifestyle.
• High-sensitivity CRP. A simple blood marker for inflammation that, alongside cholesterol and Lp(a), gives a fuller picture of your risk.
• ApoB. A blood marker that counts the actual number of artery-damaging particles in your blood, not just the amount of cholesterol they’re carrying. Two women can have identical cholesterol numbers and very different particle counts, and particle count is turning out to be one of the most reliable predictors we have. A more detailed version of this, called an NMR LipoProfile, also measures particle size, worth asking about if you want an even fuller picture.
• Coronary calcium score. Especially worth considering after menopause, since estrogen’s decline changes cardiovascular risk in ways we are rarely told about. Also helpful if your ASCVD score falls into a borderline category, since it can clarify whether medication is truly needed.
• Carotid ultrasound. Helpful if you have any of the above risk factors or a strong family history.

You may have to be the one to bring these up. That is not you being difficult; that is you being a good steward of the body you have been given.

One more note, since it comes up often. Red yeast rice contains a natural compound similar to a statin and can genuinely help lower cholesterol. It is worth a conversation with your doctor first, since it is not regulated the same way medication is, and potency varies between brands.

Five simple, lifestyle practices that support a healthy heart

None of what I shared above replaces the everyday habits that protect your heart. If anything, it makes them even more worth celebrating. One honest note before the list, if you smoke, quitting is the single biggest thing you can do for your heart, bigger than any habit below. Beyond that, here is where I put my energy.

1. Move your body most days. New research found women get significantly more heart benefit per minute of movement than men do. About 250 minutes of moderate activity a week lowered women’s heart disease risk by roughly 30 percent, and even the basic goal of 150 minutes a week made a real difference.
2. Protect your sleep. Good sleep keeps your cortisol rhythm steady, and a steady cortisol rhythm is one of the kindest things you can do for your heart.
3. Eat whole, real foods. Fiber, healthy fats, and colorful produce remain among the simplest, best-supported ways to support healthy cholesterol levels and lower inflammation.
4. Stay hydrated. Even mild dehydration thickens your blood and makes your heart work harder than it needs to.
5. Tend to your stress and your connections. Chronic stress and unmanaged cortisol affect insulin and blood pressure over time. Real connection matters here too; chronic loneliness carries cardiovascular risk comparable to smoking in some research. Community isn’t a nice extra. It is protective for your heart. It’s part of why we talk about community so often inside NOURISH, it’s not just emotional support, it’s cardiovascular support.

None of these stand alone. Movement, sleep, nutrition, hydration, stress, and connection are woven together, one tapestry, and it all eventually shows up in your heart.

Where I land on this

I share my story because I do not want another daughter finding out the way I did. My mom never got the chance to ask these questions. I get to ask them now, for both of us.

Loving yourself and caring for your body is an honor and a responsibility we all carry. Asking for the right labs, taking your family history seriously, and tending to your body well is not vanity. It is stewardship. It is obedience to the one body you have been given.

“God has not given us a spirit of fear but of power, love, and a sound mind.”
2 Timothy 1:7

If you want support figuring out what questions to bring to your own doctor, or understanding your results once you have them, that is exactly the kind of work we do together inside NOURISH, my faith-based health coaching community for women in midlife.

Learn more about NOURISH

Health and blessings,
Ann

About Ann Hackman

Ann Hackman is a certified integrative health coach and founder of NOURISH, a faith-based integrative health coaching community for women in midlife. She helps women understand their bodies, balance their hormones, and restore their health through the lens of mind, body, and spirit.

I am a certified health coach, not a physician. Please work with your doctor for personalized medical guidance.