When it comes to CVD, poor lifestyle habits matter—regardless of genetic risk
Poor behavioral lifestyle is associated with incidences of cardiovascular disease (CVD) and diabetes within and across genetic risk groups, according to new research published in the Journal of the American Medical Association.
“Genetic and lifestyle factors both contribute to the risk of developing cardiovascular disease, but whether poor health behaviors are associated with similar increases in risk among individuals with low, intermediate, or high genetic risk is unknown,” the researchers, led by Pim van der Harst, MD, PhD, of the University of Groningen in the Netherlands, wrote.
To address the paucity of research, the authors sought to investigate the association of combined health behaviors and factors within high, low and intermediate genetic risk groups with coronary artery disease, atrial fibrillation (AFib), stroke, hypertension and type 2 diabetes. They also sought to investigate the interactions between genetic risk and lifestyle.
The researchers utilized the UK Biobank cohort study and included more than 339,000 unrelated individuals of white British descent in their research, with available genotype and matching genetic data and reported gender. Individuals in the cohort were included in the analyses of one or more new-onset diseases. Approximately 54 percent of the cohort was female.
During follow-up, 3 percent of patients developed coronary artery disease (CAD), 2 percent developed AFib, less than 1 percent developed stroke, 5 percent developed hypertension and 1 percent developed diabetes.
The researchers noted genetic risk and lifestyle were independent predictors of CVD-related events. There were no interactions for any of the outcomes.
Those with poor lifestyle behaviors, in relation to ideal lifestyle in the low genetic risk group, quadrupled their risk for developing CAD and hypertension while doubling risk for stroke. Chances for developing AFib were more than five times greater. The chances for developing diabetes were 15 times greater in the high genetic risk group.
“In this large community-based population of more than 339,000 individuals, high genetic risk was associated with increased risk of new-onset CVD and diabetes events independent of lifestyle," the researchers wrote. "Within and across genetic risk groups, adherence to poor behavioral lifestyle was associated with increased risk of CVD and diabetes."
Still, the researchers noted, knowledge of genetic risk may lead individuals to believe they are destined to develop diseases regardless of lifestyle habits and may not change behavior, leading to development of CVD.
“Research in larger cohorts is needed to investigate whether genetic risk should be disclosed and, if so, which method is most effective and whether this knowledge encourages individuals to undergo stricter and earlier lifestyle intervention,” van der Harst and colleagues wrote. “Furthermore, understandable and reliable information on diseases and possible preventive measures should become easily available for patients.”
The authors wrote behavioral lifestyle changes should be encouraged for all-through comprehensive multifactorial approaches, though those at high-risk for developing CVD-related conditions may be selected because of their risk.