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Myth #4

There is no escape from heart disease if it runs in your family.

False! Genetic factors can contribute to a significantly higher risk of heart disease but one can DECREASE its risk through changing modifiable risk factors such as lifestyle and dietary habits.

Adapted from: (Mullen et al., 2021)

Polygenic and Multifactorial Heart Disease

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One of the most common heart diseases is Coronary Heart Disease.  Coronary Heart Disease, or also known as Coronary Artery Disease, is one type of Cardiovascular disease, which is caused by a buildup of plaque in the arteries, leading to clogged arteries which commonly are presented as a heart attack.

 

The common heart disease that we know of is commonly referred to as polygenic and multifactorial. Polygenic disease refers to a disease that is caused by the action of more than one gene. Thus, this would mean that heart disease is a condition that is influenced by multiple factors, which includes influence by multiple genes, alongside lifestyle and environmental factors.

What is the relationship between genetic factors and heart disease?

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Genetic factors have been known to be linked to Coronary Heart Disease, in which common variant association studies have linked about 60 genetic loci to coronary list (Khera & Kathiresan, 2017). It is estimated that the heritability of Coronary Artery Disease and Myocardial Infarction is around 50% to 60% (Dai et al., 2016). 

 

Although non-modifiable risk factors contribute to a significant percentage of its risk, suitable and early medication interventions targeting the modifiable risk factors can still lead to a substantial reduction in the onset of Coronary Artery Disease. 

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“Escaping” from this mindset

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It is important to note that there are other factors that influence the risks of Coronary Heart Disease, such as cholesterol levels, blood pressure and various lifestyle factors. The more common lifestyle factors associated with cardiovascular diseases include sedentary behaviour, smoking and poor diet.

It has been shown that by targeting these modifiable risk factors, one is able to reduce disability and premature death from coronary heart disease.

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As seen from the diagram, the more one engages in protective lifestyle factors, there will be a decreased risk of Coronary Heart Disease (Odegaard et al., 2011). Examples of protective lifestyle factors include, having a healthy diet consisting of vegetables, fruits and soy, low alcohol consumption and engaging in at least 2 hours of moderate to strenuous physical exercise per week. 

Adapted from: (Odegaard et al., 2011)
Is ignorance of a family history all bliss? 

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Although it might seems scary to learn about one's family history, knowing it can bring about their benefits too! Knowing one’s family history of heart disease can help with early detection and treatment. With the advancement of technology which allows for the early detection of family history provides more time for prevention and treatment. This was implemented in the US, which led to a more than 50% decrease in Coronary Artery Disease mortality. 

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At the end of the day, both lifestyle factors and genetic factors play a role in the onset of Coronary Heart Disease. Studies have shown that individuals with high genetic risk who adopted healthy living habits, had 46% lower relative risk of Coronary Heart Disease as compared to those with an unhealthy lifestyle (Khera et al., 2016).

  

Even if your family has a history of heart disease, don't be disHEARTened as your health habits can significantly influence your HEART health!

Written by: Yong Jia

References 

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  • Dai, X., Wiernek, S., Evans, J. P., & Runge, M. S. (2016). Genetics of coronary artery disease and myocardial infarction. World Journal of Cardiology, 8(1), 1–23. https://doi.org/10.4330/wjc.v8.i1.1

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  • Khera, A. V., Emdin, C. A., Drake, I., Natarajan, P., Bick, A. G., Cook, N. R., Chasman, D. I., Baber, U., Mehran, R., Rader, D. J., Fuster, V., Boerwinkle, E., Melander, O., Orho-Melander, M., Ridker, P. M., & Kathiresan, S. (2016, November 13). Genetic risk, adherence to a healthy lifestyle, and coronary disease [Research-article].

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  • Khera, A. V., & Kathiresan, S. (2017). Genetics of coronary artery disease: Discovery, biology and clinical translation. Nature Reviews. Genetics, 18(6), 331. https://doi.org/10.1038/nrg.2016.160

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  • Mullen, M., Zhang, A., Lui, G. K., Romfh, A. W., Rhee, J.-W., & Wu, J. C. (2021). Race and genetics in congenital heart disease: Application of ipscs, omics, and machine learning technologies. Frontiers in Cardiovascular Medicine, 8, 37. https://doi.org/10.3389/fcvm.2021.635280

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  • Odegaard, A. O., Koh, W.-P., Gross, M. D., Yuan, J.-M., & Pereira, M. A. (2011). Combined lifestyle factors and cardiovascular disease mortality in chinese men and women. Circulation, 124(25), 2847–2854. https://doi.org/10.1161/CIRCULATIONAHA.111.048843

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