CVD Risk Independently Predicted by Poor Lifestyle Factors

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Smoking, high BMI, and lower levels of physical activity were independent risk factors for CVD in individuals with high genetic risk.
Smoking, high BMI, and lower levels of physical activity were independent risk factors for CVD in individuals with high genetic risk.

Smoking, body mass index (BMI), and physical activity were independent predictors of cardiovascular disease (CVD) and CV-related events in individuals with a high genetic risk profile, according to study findings published in JAMA Cardiology.

Researchers included a total of 339,003 unrelated participants with matching genetic data from the UK Biobank cohort study. Participants were of "white British descent," between 40 and 70 years of age, and attended 22 assessment centers. The main outcome for the analysis was the risk for new-onset CVD and diabetes and the association of these risks with participants' genetic profile and health behaviors. The investigators categorized genetic risk as low (quintile 1), intermediate (quintiles 2-4), or high (quintile 5). Ideal, intermediate, and poor lifestyles were judged according to BMI, smoking status, and physical activity.

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New-onset coronary artery disease, atrial fibrillation, stroke, hypertension, and diabetes occurred in 3.0%, 2.1%, 0.9%, 4.8%, and 1.4% of patients, respectively, during a median follow-up of 6.2 years. In patients with a high genetic risk for CVD, the investigators found a significantly higher risk for incident atrial fibrillation (hazard ratio [HR], 2.33; 95% CI, 2.16-2.52; P <.001), incident coronary artery disease (HR, 1.86; 95% CI, 1.74-1.98; P <.001), incident stroke (HR, 1.24; 95% CI, 1.12-1.38; P =6.9×10−5), incident diabetes (HR, 1.91; 95% CI, 1.74-2.10; P <.001), and incident hypertension (HR, 1.44; 95% CI, 1.36-1.53; P <.001).

Individuals who had poor lifestyle (eg, high BMI, low physical activity levels, and were smokers) and had high genetic risk had an increased risk for atrial fibrillation (HR, 5.41; 95% CI, 4.29-6.81, P <.001), coronary artery disease (HR, 4.54; 95% CI, 3.72-5.54, P <.001), hypertension (HR, 4.68; 95% CI, 3.85-5.69, P <.001), stroke (HR 2.26; 95% CI, 1.63-3.14, P <.001), and diabetes (HR, 15.46; 95% CI, 10.82-22.08, P <.001) compared with individuals with an ideal lifestyle and low genetic risk.

The use of self-reported data for determining participants' lifestyle, as well as the observational nature of the analysis, were 2 limitations of this study.

Researchers suggested that "behavioral lifestyle changes should be encouraged for all through comprehensive multifactorial approaches, although high-risk individuals may be selected based on their [genetic risk]."

Reference

Said MA, Verweij N, van der Harst P. Associations of combined genetic and lifestyle risks with incident cardiovascular disease and diabetes in the UK Biobank Study [published online June 27, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.1717

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