Lifestyle vs. Genes for Cardiovascular Health?

It is well known that genes play a role in determining who has a higher risk for cardiovascular disease, such as heart attacks and strokes. But we also know that lifestyle factors determine risk as well. In confirmation of this, researchers from Northwestern University reported, at the 2010 meeting of the American Heart Association, that a healthy lifestyle actually has a bigger impact than does inheritance on cardiovascular disease (CVD).

Research findings on lifestyle factors that make a difference

• The investigators considered five healthy lifestyle factors:
• Not smoking
• Low or no alcohol intake
• Weight control
• Physical activity
• Healthy diet

One of their studies found that 60 percent of individuals who adopted all five healthy lifestyle factors as young adults and followed them for 20 years remained at low risk for CVD (heart attacks and strokes) in middle age. By contrast, among those who maintained none or just one of the healthy lifestyle factors only 6 percent were at low risk in middle age.

A study of three generations confirms the importance of behavior

Their second study examined the cardiovascular health of about 16,500 people who were part of three generations of families from the Framingham Heart Study. The results showed that only a small portion of CVD risk was determined by the cardiovascular health of the parents. Rather, risk status was predominantly due to lifestyle and behaviors.

Family history is still important

I completely agree that maintaining good lifestyle habits is critical for preventing CVD events and deaths. However, people at high risk–because of a family history of premature CVD, high blood pressure, diabetes, of a high cholesterol, whether inherited or not–may need to do more than merely follow healthy lifestyle measures. At least by their 20s or early 30s everyone needs a visit to a physician or an examination at some screening center to learn whether they have high cholesterol levels or high blood pressure. Early management of these risk factors with either specific lifestyle measures or medications is the best  prescription for preventing CVD in such high risk people.

Continued genetic research is still needed

Further, even if genetic factors presently appear to have a relatively limited effect on CVD, it is extremely important to continue studies on the genes involved in CVD, diabetes, elevated cholesterol levels, and high blood pressure. Results of such studies may identify more people, possibly only in small numbers, who have inherited genetic abnormalities that puts them at high risk for CVD or one of the its major risk factors. In addition, discovery of the genes that predispose to these disorders will provide better understanding of their underlying causes. Such understanding, in turn, may be the key to developing more effective and safer medications for treating or preventing these disorders.