Carotid artery narrowing

Hello, I am a 47 yo female just diagnosed with carotid artery narrowing <50%.  Also have mitral valve prolapse.  Father died of heart attack at 54 years and brother at 41yo.  Am I genetically predestined to heart disease?   I do not smoke, drink and exercise 6 days a week with walks, treadmill running and elliptical, weightlifting 3X/weekly.   Will be seeing internist soon, what questions should ask at next appointment?

[SandyDH]

What were your symptoms before being diagnosed with Carotid Atery narrowing?

[judiann2448]

Internist heard bruit in carotid artery during routine exam.  Diagnosed after ultrasound with mild carotid artery stenosis, <50%.  Recently found out my father and brother had atherosclerosis.  My ultrasound showed no plaque in carotid arteries.  Going to cardiologist for yearly echo for moderate mitral regurg so will get more info from him re: carotid stenosis.

[Lee Kirksey, MD]

Hello
It sounds like you do have some familial tendency to develop premature atherosclerosis. For premenopausal women, estrogen appears to have some protective affect in preventing develoment of atherosclerotic changes.  After about 3-5 years post menopausal, the incidence of atherosclerosis equals men.

What is your cholesterol level, specifically the breakdown of LDL(remember "l" for lousy and hdl) You need to have an aggressive evaluation to uncover any reversible predisposing conditions and to have those treated. When treating individuals with this type of family history, I pull out all stops in diagnosing conditions early; sometimes even employing chemistries and diagnostic tests that would not be offered to low risk, asymptomatic patients

[judiann2448]

Recently had a NMR Lipoprofile:

LDL-P was 1040
Small LDL-P was 513
Total cholesterol 155 with LDL-C 94.  
HDL-C was 50 and triglycerides 55.  
LDL Particle size 21.6, large HDL-P was 11.9 and large VLDL-P was .04
C-reactive protein 1.07

Did recently find out brother did not die of heart attack but suicide.  Father had massive heart attack; both were heavy smokers and alcoholics.  I do have a brief history of smoking but do not drink.  Very active, at the gym 5x week along with long walks 6x week.  
Imaging report for carotid ultrasound showed "mild intimal thickening bilaterally" and "antegrade vertebral flow is present".  Any info you can give on these readings would be greatly appreciated.