Coronary heart disease and genetics in epidemiologist's view

We are just beginning to uncover the genetic determinants of coronary heart disease. The genotype-phenotype associations are complex as a consequence of pleiotropy, variation with age, selection owing to the high lethality of the disease, and interactions between genes and with environmental factors. Nevertheless, identification of the gene variants involved in the chronic and acute processes of coronary heart disease appears possible; this could considerably improve our understanding of the aetiology and mechanisms of this disease. Simultaneous analysis of several predisposing alleles should provide the means to identify high-risk individuals and to adapt therapeutic approaches to the genetic make-up of patients.