In a new study, researchers found physical inactivity, smoking, high blood pressure, diabetes, and high cholesterol play a greater role than genetics in many young patients with heart disease.
They suggest healthy behaviors should be a top priority for reducing heart disease even in those with a family history of early-onset.
The research was conducted by a team from Portugal.
Genetics are an important contributor to premature heart disease.
Many young patients with premature heart disease ‘seek shelter’ and explanations in their genetics/family history.
But the current study shows young patients with heart disease are frequently smokers, physically inactive, with high cholesterol levels and high blood pressure—all of which can be changed.
The study enrolled 1,075 patients under 50, of whom 555 had coronary artery disease (known as premature CAD).
Specific conditions included stable angina, heart attack, and unstable angina. The average age was 45 and 87% were men.
The team examined 5 lifestyle risk factors: physical inactivity, smoking, high blood pressure, diabetes, and high cholesterol.
They found nearly three-quarters of patients had at least three of these risk factors compared to 31% of healthy people.
In both groups, the likelihood of developing heart disease increased exponentially with each additional risk factor.
All participants underwent genome sequencing. These data were used to develop a genetic risk score containing 33 variants thought to contribute to heart disease or high blood pressure.
The average score was higher in patients than controls. However, the contribution of genetics to the risk of heart disease declined as the number of lifestyle factors rose.
The team found in patients with two or more lifestyle cardiovascular risk factors, genetics play a less important role in the development of heart disease.
They say people with a family history of premature heart disease should adopt healthy lifestyles, since their poor behaviors may be a greater contributor to heart disease than their genetics.
That means quitting smoking, exercise regularly, eat a healthy diet, and get blood pressure and cholesterol levels checked.
The lead author of the study is Dr. Joao A. Sousa of Funchal Hospital.
The study was presented at ESC Congress 2019 together with the World Congress of Cardiology.
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