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Utility of genetic determinants of lipids and cardiovascular events in assessing risk

Michael V Holmes1, Seamus Harrison, Philippa J Talmud

  • 1Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.

Nature Reviews. Cardiology
|February 16, 2011
PubMed

Insights

Genetic testing offers a promising approach for predicting coronary heart disease (CHD) risk, addressing the prevention paradox by enabling early, individualized strategies. This review explores its applications and challenges for public health.

Area of Science:

  • Cardiovascular Disease Epidemiology
  • Medical Genetics
  • Public Health

Background:

  • Coronary heart disease (CHD) prevention is a key public health objective.
  • The "prevention paradox" highlights that most clinical events occur in the general population, not just high-risk individuals.
  • Recent genetic discoveries have reignited the debate between individualized and population-based prevention strategies.

Purpose of the Study:

  • To review the potential applications and challenges of using genetic information for CHD risk prediction.
  • To focus on genetic predictors related to lipid risk factors.
  • To draw parallels with the evaluation of non-genetic risk factors for CHD screening.

Main Methods:

  • Review of current literature on genetic testing for CHD risk.
  • Analysis of genetic information in the context of the prevention paradox.
  • Examination of lipid risk factors and their genetic underpinnings.
  • Comparison with established methods for evaluating non-genetic screening tests.

Main Results:

  • Genetic testing is a low-cost, high-fidelity tool for CHD risk prediction.
  • Genotype is invariant, enabling prediction from early life and reducing biological variability.
  • The review highlights both the promise and the practical challenges of implementing genetic screening for CHD.

Conclusions:

  • Genetic information holds significant potential for refining CHD risk prediction and guiding personalized prevention strategies.
  • Addressing the prevention paradox requires careful consideration of how genetic data can be best utilized for broad public health benefit.
  • The principles discussed are applicable to other common, late-onset diseases with modifiable risk factors.

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