Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease

Khera, A.V. et al. NEJM. Published online: 13 November 2016

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Image source: Bill McConkey – Wellcome Images // CC BY-NC-ND 4.0

Background: Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown.

Methods: Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts — 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) — and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet.

Conclusions: Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.

Read the full article here

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Person and community-centred approaches to health and wellbeing

The Health Foundation in partnership with the innovation charity Nesta has published two reports in their Realising the Value series which aims to strengthen the case for people taking an active role in their health and care.

A healthier life for all

The Health Foundation and the All-Party Parliamentary Health Group have published A healthier life for all: the case for cross-government action.

The report is a collection of essays setting out the current and emerging threats to health and wellbeing and what we know about what works to address them.  The collection concludes that addressing the wider determinants of health is critical to ensuring the prosperity and wellbeing of British society as well as easing pressure on the NHS.

The essays support the view that a more proactive approach to tackling poor health across all policy areas is urgently needed.

Mediterranean diet ‘as effective as statins’ in reducing heart attack risk

Leading doctors call on medical bodies such as Nice to do more to promote healthy lifestyles rather than relying on cardiovascular drugs

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People at risk of a stroke or heart attack should reduce that risk by adopting the Mediterranean diet rather than necessarily taking statins, leading doctors are urging.

Eating more healthily, being more physically active and stopping smoking can be just as effective as starting to take the cholesterol-lowering drugs, they have said in a paper published on Monday.

Bodies such as the National Institute for Health and Clinical Excellence (Nice), which advise doctors how to treat patients, should rely less on medication to cut cardiovascular risk.

The call, in an editorial in the healthcare journal Prescriber, has come from a trio of doctors, including the British cardiologist, Dr Aseem Malhotra, a prominent sceptic about the value of statins. They believe doctors should tell patients in detail about the risks and benefits of using statins or the alternative of making non-medical, lifestyle changes, and let them decide which approach they favour.

Read the full article via Mediterranean diet ‘as effective as statins’ in reducing heart attack risk | Society | The Guardian.

The editorial article referenced can be found here