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Genetic Risk, Adherence to a Healthy Lifestyle, and Ischemic Heart Disease
Thomas F Whayne1,2, Sibu P Saha3
1Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA. twhayn0@uky.edu.
Insights
This review highlights the underappreciated roles of genetic risk and therapeutic lifestyle changes (TLC) in coronary artery disease (CAD) management. Understanding specific genetic factors and adhering to TLC are crucial for comprehensive patient care.
Area of Science:
- Cardiology
- Genetics
- Preventive Medicine
Background:
- Coronary artery disease (CAD) management often overlooks genetic predisposition and lifestyle interventions.
- Genetic risk is traditionally linked to broad cardiovascular (CV) risk factors, but future understanding involves specific genes, genetic risk scores, SNPs, and miRNAs.
- Therapeutic Lifestyle Change (TLC) includes physical fitness, exercise, behavioral modification, diet, and stress reduction.
Purpose of the Study:
- To investigate and discuss the significance of genetic risk and TLC in coronary artery disease (CAD).
- To emphasize the inadequate attention these crucial aspects receive in patient care.
Main Methods:
- Review of current literature on genetic risk factors for CAD.
- Analysis of the components and impact of Therapeutic Lifestyle Change (TLC) on cardiovascular risk reduction.
- Exploration of the interplay between genetics, epigenetics, and TLC.
Main Results:
- Genetic risk assessment is evolving towards identifying specific genetic markers (SNPs, miRNAs) and developing genetic risk scores.
- Each component of TLC independently contributes to reducing CV risk.
- TLC can influence gene expression through epigenetic mechanisms.
Conclusions:
- Both genetic risk and TLC are vital for comprehensive CAD management.
- Despite the focus on pharmaceutical interventions like statins, the impact of TLC, dependent on patient adherence, should not be neglected.
- Further research into personalized genetic risk and optimized TLC strategies is warranted.
Purpose Of Review:
The purpose of this review is to investigate and discuss two aspects of coronary artery disease (CAD)-genetic risk and therapeutic lifestyle change (TLC)-both of which have key importance for patients and their care but which actually receive inadequate attention.
Recent Findings:
Genetic risk has generally been relegated to a broad association with the presence of one or more inherited cardiovascular (CV) risk factors such as hypercholesterolemia, family history of atherosclerosis, hypertension, and diabetes mellitus. However, the future of genetic risk is an understanding of specific genes, a genetic risk score, specific genetic loci known as selective nucleotide polymorphisms (SNPs), specific alleles, and microribonucleic acids (miRNAs). Healthy lifestyle is fashionably referred to as TLC and encompasses physical fitness, exercise, behavioral modification, diet, and stress reduction. In the past decade, aggressive treatment of cholesterol with statins has received the major emphasis for CV risk reduction. Genetics, of course, can only be modified by factors that influence epigenetics, and TLC could have an effect on genetics by this mechanism. On the other hand, each individual component of TLC has been shown to contribute to a reduction of CV risk. Although aggressive pharmaceutical approaches are now in vogue, whatever TLC can contribute, depending on the degree of individual patient adherence, should never be forgotten.
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