Coronary artery disease is one of the most common cardiovascular events causing damage to the heart muscle and death globally. A new lead study has revealed that adherence to a healthy lifestyle reduces the onset of coronary artery disease in people with increased genetic risk.
Generally, the most common risk factors which are involved in coronary artery disease onset include levels of cholesterol, blood pressure, family history, diabetes, smoking etc. Some of the literature studies reported that both genetic and lifestyle factors play an important role in cardiovascular events. A collaborative study in this direction by senior author Sekar Kathiresan, director of the Center for Human Genetics Research, Massachusetts General Hospital, USA, and colleagues, revealed that healthy lifestyle may reduce the increased genetic risk of coronary artery disease. The results of the current study were published online in the New England Journal of Medicine in 2016.
This research study, on whether healthy lifestyle reduces genetic risk, was carried on 55685 participants in four large cohorts. Among them, three were prospective cohorts which included Atherosclerosis Risk in Communities (ARIC) (n=7814), Women’s Genome Health (WGHS)(n=21,222) and Malmo Diet and Cancer Study (MDCS) (n=22,389) and the fourth was a cross-sectional study cohort which was from BioImage (n=4260). Gene polymorphisms and clinical data were analyzed by the researchers in the current study to determine the polygenic score for genetic risk and adherence score for healthy lifestyle patterns based on the strategic goals of the American Heart Association (AHA) on coronary artery disease.
The results of the three prospective cohort studies have revealed an increased risk (hazard ratio (HR)-1.91) of coronary events in 91% of the participants with high genetic risk. It was also noted that cohorts with favourable lifestyle pattern were at lower risk of coronary events regardless of the genetic risk category. 46% of the participants following a healthy lifestyle while in the high genetic risk cohort were at lower risk (HR- 0.54) of coronary events than those with unfavourable lifestyle. This corresponds to a reduction in the occurrence of coronary events from 10.7% for an unfavourable lifestyle to 5.1% for a favourable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage study group, all the genetic risk groups with favourable lifestyle were significantly associated with low-level calcification of coronary arteries.
In summary, following a healthy lifestyle pattern modifies the genetic risk profile of coronary artery disease, indicating that DNA is not the destiny. Limitations related to healthy lifestyle pattern which is not randomized, different methods adopted by researchers in determining lifestyle at baseline and polygenic score of only 50 previously validated genetic polymorphisms.
Further studies in different populations and specific lifestyle patterns will give more pronounced risk gradients for coronary events.
Written By: Manche Santoshi, PhD