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Even for people genetically predisposed to heart disease, healthy lifestyle significantly lowers risk

For coronary heart disease risk, genes may not be destiny. New research suggests that even for people at high genetic risk for heart disease, a healthy lifestyle can substantially reduce that risk.

The large study included data on more than 55,000 people from three prospective studies and one cross-sectional study. Genetic risk levels were calculated by testing for more than 50 genetic variations linked to heart disease. The participants were then divided into five groups (quintiles), ranging from highest genetic risk to lowest.

A healthy lifestyle was based on four factors: not currently smoking, not being obese, exercising at least weekly, and eating a healthy diet. People with three or four of these factors were in the healthy lifestyle group. Those with two favourable lifestyle factors were classified as intermediate, and those with only one or zero favourable factors were in the unhealthy lifestyle group.

The 51,425 participants in the prospective studies were followed for average periods ranging from 18.8 years 20.5 years. During that time, there were a total of 5,103 coronary events (heart attack, revascularization such as a coronary bypass or angioplasty, or death from coronary causes).

People in the highest genetic risk quintile had 91 per cent higher risk of coronary events than people in the lowest genetic risk quintile.

However, a healthy lifestyle was associated with significantly lower risks of coronary events at every genetic risk level. The group that gained the most benefits from a healthy lifestyle was the highest genetic risk group. A healthy lifestyle lowered the absolute risk of coronary events by 45 per cent in this group, compared to an unhealthy lifestyle.

Not only could a healthy lifestyle offset a high genetic risk of heart disease, but an unhealthy lifestyle could offset a low genetic risk.

The data from the fourth study included in the research showed that healthy lifestyle was significantly linked to decreased coronary artery calcification at every genetic risk level.

The researchers note three important conclusions:

  • genetic factors and lifestyle factors appear to influence heart risks independently
  • healthy lifestyle factors reduced coronary event rates in every genetic risk group
  • high genetic risk for coronary disease does not set the future in stone: lifestyle factors can substantially modify that risk

The study was led by Dr. Amit Khera of Massachusetts General Hospital in Boston, Mass., and Connor Emdin, D.Phil., of the Broad Institute in Cambridge, Mass. It was published online in the New England Journal of Medicine on Nov. 13, 2016.




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  • A publication of:
  • Women's College Hospital