Individuals with a family history of premature coronary heart disease (CHD) have increased cardiac morbidity and mortality, which may motivate them to modify their health behaviours. This analysis examines whether patients with self-reported family history of premature CHD experiencing an acute coronary syndrome (ACS) were more likely to have their risk factors and health behaviours under control at 12 months post ACS. Data from the TEXTMEDS study were used to estimate the association between self-reported family history of premature CHD and blood pressure control, LDL cholesterol control, BMI, exercise and smoking status at 12 months post ACS. The study cohort consisted of 1423 participants (mean age 58.0 ± 10.67, 79.2% male), with 556 (39.1%) reporting a family history of premature CHD, while 867 (60.9%) reported no family history. No evidence from this analysis suggests that patients with knowledge of their family history were more likely to achieve better risk factor control. Novel strategies for risk factor control in this high-risk population is required to improve secondary prevention.