Premature heart disease is more strongly linked to lifestyle than genetics
New research from the European Society of Cardiology has revealed that in many young patients, lifestyle factors make the largest contribution to heart problems. Physical inactivity, smoking, high blood pressure, diabetes, and high cholesterol were all found to have a stronger influence on premature heart disease than genetics.
The findings suggest that healthy behaviors should be the biggest priority for reducing the risk of heart disease, even in those with a family history of this condition.
“Genetics are an important contributor to premature heart disease but should not be used as an excuse to say it is inevitable,” said study author Dr. Joao A. Sousa of Funchal Hospital in Portugal.
“In our clinical practice, we often hear young patients with premature heart disease ‘seek shelter’ and explanations in their genetics/family history. However, when we look at the data in our study, these young patients were frequently smokers, physically inactive, with high cholesterol levels and high blood pressure – all of which can be changed.”
The study was focused on 555 patients under the age of 50 who had premature coronary artery disease (CAD). The group was 87-percent male with an average age of 45. The researchers compared the risk factors and genetics of these patients to a control group of 520 healthy volunteers with an average age 44, who were also mostly males.
Of the five modifiable lifestyle factors that were examined in the study, nearly 73 percent of patients had at least three of these risk factors compared to only 31 percent of individuals in the control group.
The chances of developing CAD drastically increased with each additional risk factor in both groups. The presence of two extra risk factors increased the likelihood of CAD by seven times, while an individual with three extra risk factors was 24 times more likely to develop the condition.
The average genetic risk score was higher in patients than controls, and was found to be an independent predictor for premature CAD. However, the contribution of genetics declined as the number of modifiable risk factors increased.
“The findings demonstrate that genetics contribute to CAD,” said Dr. Sousa. “However, in patients with two or more modifiable cardiovascular risk factors, genetics play a less decisive role in the development of CAD.”
“Our study provides strong evidence that people with a family history of premature heart disease should adopt healthy lifestyles, since their poor behaviors may be a greater contributor to heart disease than their genetics. That means quit smoking, exercise regularly, eat a healthy diet, and get blood pressure and cholesterol levels checked.”
The research was presented at ESC Congress 2019.
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