I was adopted at birth and do not know my genetic history. Is it important for me to see a cardiologist at any time?

I’m a 44-year-old male 6ft, 185lbs, adopted at birth. I do a yearly blood work with good results, I have also been on Testosterone therapy for 2 years, prescribed by my family doctor. My question is when, or if ever, should I see a cardiologist since I have no family history? Is blood work enough or should I ask more questions on my next visit?

Submitted by Scott from Texas on 05/08/2015

Dear Scott,
I don’t think that this is as much of a handicap as one might think. As far as heart disease is concerned, congenital heart disease is easily detected by non-invasive means. Genetic counseling is important for YOUR offspring. It was not an option for your biological parents. It turns out that in families with a history of premature coronary disease, smoking is an important trigger that increases risk. Currently we have reasonably effective screening tools for most common diseases such as diabetes, hypertension, cancer, and heart disease. As our knowledge of genetics increases, an individual’s risk for developing a specific condition can be evaluated by genetic testing which is much more accurate than family history.

Meanwhile, periodic physical examinations, BP measurements, blood work such as CBC, blood sugar, kidney and liver parameters, PSA, an initial ECG and treadmill test at age 40, colonoscopy, and mammography are recommended. The type and frequency of these tests are determined by epidemiologic data from which guidelines are being developed.

Controlling blood pressure, maintaining a normal weight, not smoking, and controlling blood sugar and lipids are important regardless of family history. I recommend to my patients that they take advantage of the ultrasound screening tests that are periodically offered at a reasonable price. These screening tests are rarely covered by ordinary insurance.

I am concerned about your testosterone therapy since this is controversial and needs to be individualized to minimize undesirable side effects such as aggravating arteriosclerosis, and increasing the risk of prostate cancer. I recommend that you review the indications with the prescribing physician.

I hope this answers your question.