Relevance of Genetics and Genomics for Prevention and Treatment of Cardiovascular Disease

Abstract

Abstract-Atherosclerotic cardiovascular disease (CVD) is a major health problem in the United States and around the world. Evidence accumulated over decades convincingly demonstrates that family history in a parent or a sibling is associated with atherosclerotic CVD, manifested as coronary heart disease, stroke, and/or peripheral arterial disease. Although there are several mendelian disorders that contribute to CVD, most common forms of CVD are believed to be multifactorial and to result from many genes, each with a relatively small effect working alone or in combination with modifier genes and/or environmental factors. The identification and the characterization of these genes and their modifiers would enhance prediction of CVD risk and improve prevention, treatment, and quality of care. This scientific statement describes the approaches researchers are using to advance understanding of the genetic basis of CVD and details the current state of knowledge regarding the genetics of myocardial infarction, atherosclerotic CVD, hypercholesterolemia, and hypertension. Current areas of interest and investigation-including gene-environment interaction, pharmacogenetics, and genetic counseling-are also discussed. The statement concludes with a list of specific recommendations intended to help incorporate usable knowledge into current clinical and public health practice, foster and guide future research, and prepare both researchers and practitioners for the changes likely to occur as molecular genetics moves from the laboratory to clinic.

Genetic and environmental influences on factors associated with cardiovascular disease and the metabolic syndrome

“…For example, genetic polymorphisms for proteins involved in lipoprotein metabolism, such as apoE, cholesteryl ester transfer protein, and hepatic lipase, have been either identifi ed as candidate genes for CVD risk or found to modify the lipid response to dietary change ( 63,64 ). The moderate heritability estimates of the other cardiometabolic syndrome components is also consistent with previous reports of genetic polymorphisms for proteins that impact on obesity, blood pressure, or insulin resistance, such as peroxisome proliferator-activated receptor ␥ , angiotensinogen, and calpain-10, respectively ( 62,65,66 ).…”

“…Although the potential contribution of genetic and environmental infl uences to cardiometabolic syndrome components has received considerable attention ( 62 ), current estimates of the heritability vary widely and are only available for a subset of those components. Furthermore, despite attempts to identify an underlying pathology of MetS, few studies have examined whether MetS components share common genetic and environmental infl uences.…”

Associations of Noise and Socioeconomic and -Demographic Status on Cardiovascular and Respiratory Diseases on Borough Level in a Large German City State

“…Furthermore, besides genetic disposition, family history, and previous atopic disease [49,50], individual behavioral factors such as smoking status including passive smoking, alcohol intake, or physical activity, awareness for diseases such as hypertension and factors describing the daily routine are discussed to be associated with the occurrence of different cardiovascular and respiratory health outcomes [7,23,[35][36][37][51][52][53][54][55].…”

A genome-wide association study-derived candidate gene seeks replication: STK39

“…This locus was subsequently associated with other vascular phenotypes, such as sudden and/or arrythmic cardiac death, peripheral artery disease, carotid plaques, abdominal aortic and cerebral aneurysms and -though less consistentlyischemic stroke [5]. Accordingly, in a statement of the American Heart Association, Arnett et al [6] considered that GWAS might well become the primary research methodology for the discovery of cardiovascular disease genes in the near future.…”