Although heart disease risk begins to rise in middle age, if you have a family history of early heart disease, you may require earlier monitoring.

Several types of heart problems can run in families. One of the most common of these conditions is familial hypercholesterolemia. One in 200 people have a genetic mutation that prevents their body from clearing “bad” LDL cholesterol. Statin drugs can be a lifesaver for people with familial hypercholesterolemia.

If your family has a history of premature heart disease, you should also ask your doctor for an advanced lipid screening. This test can show whether you have inherited lipoprotein(a), a type of small, dense LDL cholesterol that can damage your coronary arteries, setting the stage for heart disease. Although there is no recognized treatment for people with lipoprotein(a), I’ve found that taking 500 mg to 2,500 mg of vitamin B3 (niacin) can alter the harmful particles to fluffier cholesterol particles less likely to damage arteries. But you need to get the proper test to ascertain your risk.

Sudden cardiac arrest, in which the heart unexpectedly stops beating, can also be caused by a genetic condition. If your family has a history of sudden death, discuss genetic testing with your doctor. In addition, congestive heart failure and atrial fibrillation can run in families.

A woman’s health during pregnancy can also be a tip-off. If a woman developed high blood pressure or diabetes during pregnancy (gestational diabetes), her doctor may want to monitor her heart health earlier than usual.