Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease
Written by Editor   
Tuesday, December 20, 2016 12:00 AM

News Bite:  Want to cut your risk of coronary artery disease nearly in half regardless of your genetic predisposition to it?  Research indicates that having three out of four of the following will do it:  no current smoking; no obesity; regular physical activity; healthy diet.  If we help our patients toward these goals statistics indicate that a substantial reduction in coronary artery disease would result.


Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown.  Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.

Using a polygenic score of DNA sequence polymorphisms, researchers quantified genetic risk for coronary artery disease in three prospective cohorts — 7,814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) — and in 4,260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. They also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet.

The relative risk of incident coronary events was 91% higher among participants at high genetic risk than among those at low genetic risk. A favorable lifestyle (defined as at least three of the four healthy lifestyle factors) was associated with a substantially lower risk of coronary events than an unfavorable lifestyle (defined as no or only one healthy lifestyle factor), regardless of the genetic risk category. Among participants at high genetic risk, a favorable lifestyle was associated with a 46% lower relative risk of coronary events than an unfavorable lifestyle. This finding corresponded to a reduction in the standardized 10-year incidence of coronary events from 10.7% for an unfavorable lifestyle to 5.1% for a favorable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage Study, a favorable lifestyle was associated with significantly less coronary-artery calcification within each genetic risk category.