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Risk, Genetics and Special Populations

Who is most at risk, why genetics matters, and what changes for specific groups – menopause, family history, and more.

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Imagine a man named Mark. Mark is 48 years old, and lately, he feels like a shell of his former self. Every day around 3:00 PM, he hits a "wall" of exhaustion that feels like swimming through deep mud. His "brain fog" makes it hard to focus at work, and he has completely lost the "spark" for his hobbies and his relationships. He is tired, moody, and just wants to nap.
Most people think a heart attack is like a lightning strike. One minute you are fine, and the next, everything changes. But science shows that heart disease is not a sudden accident. It is more like a slow story that takes forty or fifty years to write.
Most people think that "clogged arteries" are just a normal part of getting old. We treat heart disease like grey hair or wrinkles—something that eventually happens to everyone if they live long enough. But what if that is wrong?
Imagine your body is a car, and your health is tracked by an odometer. For most of us, that odometer ticks up slowly and steadily. We might drive for 50 or 60 years before the engine starts to show significant wear and tear. But for some children, the odometer is spinning wildly out of control from the moment they are born. This is the reality of Homozygous Familial Hypercholesterolemia, or HoFH.
There are hundreds of heart health apps on the market today. Most of them do the same thing: they monitor your heart rate, track your steps, measure your sleep, and tell you to eat more vegetables. Some of the more sophisticated ones connect to wearables and give you a real-time readout of your pulse. A few will even flag an irregular heartbeat.
Not all fat is the same — and where your body stores it turns out to matter a lot more than how much you weigh. Have you ever noticed that two people can weigh exactly the same and be completely different when it comes to their health? That’s because weight alone doesn’t tell the whole story. Scientists have discovered that where your body stores fat is what really matters — and fat stored deep in your belly, called visceral fat, is in a league of its own when it comes to health risks.
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