Genetics should not be used as “an excuse”
Study author Joao Sousa of Funchal Hospital, Portugal, says that although genetics is an important contributor to premature heart disease, it should not be used as an excuse to assume its development is inevitable.
“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." - Joao Sousa, Study Author
Assessing risk factors for heart disease
For the study, the researchers recruited 1,075 (aged an average of 45 years), of whom 555 had premature coronary artery disease (CAD). Specific conditions included stable angina, unstable angina and heart attack.
The researchers performed genomic sequencing and assessed five modifiable risk factors associated with heart disease, which were physical inactivity, smoking, hypertension, diabetes and high cholesterol.
They then compared the results with those from 520 healthy controls aged an average of 44 years. Both patients and controls were enrolled from the Genes in Madeira and Coronary Disease (GENEMACOR) database.
The more modifiable risk factors, the greater the risk
Almost three-quarters (73%) of the premature CAD patients had at least three of the risk factors, compared with only 31% of the control group.
In both groups, the odds of developing CAD significantly increased with each additional risk factor.
For those with only one risk factor, the likelihood of CAD was three times higher, compared with seven times higher with two risk factors and a startling 24 times higher with three risk factors.
All study participants underwent genomic sequencing and the team created a genetic risk score that covered 33 variants thought to be contributors to CAD risk.
The average risk score was significantly higher among patients than among controls and was also an independent predictor of premature CAD. However, the more modifiable risk factors the patients had, the less genetics contributed to CAD risk.
He concluded that the findings provide strong evidence that people with a family history of premature CAD should adopt healthy lifestyle habits, since unhealthy habits may be a more significant contributor to the risk for heart disease than their genetics.
“The findings demonstrate that genetics contribute to CAD. However, in patients with two or more modifiable cardiovascular risk factors, genetics play a less decisive role in the development of CAD… That means quit smoking, exercise regularly, eat a healthy diet, and get blood pressure and cholesterol levels checked." - Joao Sousa, Study Author
Habits to adopt for a healthy lifestyle
Some lifestyle changes that people can make to reduce their risk for heart disease are given below.
1. Follow a healthy diet
Diets that are high in saturated fats, trans fat and cholesterol have been associated with an increased risk for heart disease and associated conditions such as atherosclerosis. High salt intake can also increase blood pressure.
Following a diet low in fat, but rich in nutrients such as vitamins minerals and fiber helps to reduce these risks. Recommended foods include vegetables, fruits, whole grains, fish, poultry, legumes, nuts and non-tropical vegetable oils.
2. Get physically active
Physical activity can lower the risk of heart disease by helping to lower blood pressure, cholesterol, and weight. Being physically active every day is recommended, although any amount of physical activity is better than none.
Research has shown that people who only achieve a moderate level of fitness are still at a significantly reduced risk for premature death than those with a low fitness level.
3. Reduce alcohol intake
A high alcohol intake can increase heart disease risk by raising blood pressure and triglycerides. Women are advised to drink no more than one alcoholic beverage per day, while men are advised to drink no more than two.
4. Stop smoking
Tobacco smoking can damage the heart and vasculature, which increases the risk of heart disease and heart attack. It also increases blood pressure and lowers the amount of oxygen that the body can carry. Although giving up smoking is difficult, it is not as difficult as trying to recover from a heart attack or stroke.
5. Reduce cholesterol levels
Cholesterol accumulation in the arteries can trigger a heart attack or stroke. If physical activity and a healthy diet do not bring the cholesterol level down, medication can be prescribed.
6. Maintain a healthy weight
Obesity increases the risk for high cholesterol, hypertension and insulin resistance, which is a precursor for type 2 diabetes. Following a nutritious diet, controlling calorie intake and being physically active are the only ways to maintain a healthy weight.
7. Reduce stress
Some research has shown an association between stress and coronary heart disease. Stress may cause people to start smoking, smoke more than usual or overeat. Some studies have even shown that stress is a predictor of middle-aged blood pressure risk among young adults.