Coronary Heart Disease: Risk Genes Are Not Fate

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It is well known that a healthy lifestyle - in particular abstaining from nicotine, regular exercise, a balanced diet and a normal body mass index (BMI) prevents heart disease. But does that also apply if you already carry a genetic risk for such diseases?

"The basic message of our study is: DNA is not fate," said Sekar Kathiresan, director of the Center for Human Genetics at Massachusetts General Hospital (MGH) in Boston. Many people, including doctors, had previously considered the genetic risk to be inevitable. "But when it comes to a heart attack, that doesn't seem to be the case," he found.

Gene variants as an indication of the CHD risk

Kathiresan and his team analyzed the genetic information of 55,000 test subjects and checked whether they had one or more of 50 gene variants that are associated with an increased risk of heart attack.

In this way, the scientists calculated an individual risk score. In addition, they determined four lifestyle factors for each study participant: whether the test subjects smoked, how healthy they ate, how high their BMI was and how often they were physically active.

Now the researchers examined how genetic risk score and lifestyle factors affect the risk of coronary artery disease (CHD), a heart attack or sudden cardiac death.

Twice the risk for CHD

The team was able to show that a high genetic risk score almost doubled the CHD risk compared to unexposed people. On the other hand, subjects with a high score could almost halve their CHD risk if they lived healthy.

"Some people think they cannot escape the genetic risk of a heart attack. But our results suggest that a healthy lifestyle can partly outweigh the genetic risk," says Kathiresan. In further studies, the researchers now want to investigate whether some lifestyle factors have a stronger impact than others.

Lack of oxygen in the heart muscle

In coronary heart disease, the blood vessels that supply the heart muscle with oxygen "calcify". The result is insufficient blood flow to the heart with a lack of oxygen, which can lead to the sudden death of muscle tissue or severe cardiac arrhythmias. CHD is the leading cause of death in western industrialized countries.

Sources:

Khera A. et al .: Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease. New English Journal of Medicine. DOI: 10.1056 / NEJMoa1605086

Massachusetts General Hospital press release of November 13, 2016: Study finds following a healthy lifestyle can greatly reduce genetic heart attack risk

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