[The contribution of genetics in the evaluation of cardiovascular risk]

A family history of cardiovascular disease is an important factor in the evaluation of a given individual's cardiovascular risk. The determination of this factor may be congenital or acquired. Behavioural modes common to members of the same family may increase predisposition to cardiovascular disease at an early age and thereby simulate a genetic risk factor. However, a genetic component of cardiovascular risk has been demonstrated, mainly thanks to twin studies. It is a multigenic factor. Contrary to monogenic diseases in which rare mutations of a single gene will, with a high relative risk, produce a rare disease, in the case of multigenic diseases, several genes which have frequent mutations will, with a low relative risk related to each gene, interact to cause a common disease. Thus, the family history of cardiovascular disease covers a large number of common mutations or polymorphisms, the detection of which has been greatly facilitated by the explosion of modern techniques of molecular biology over the last few years. The dissection of these factors of genetic predisposition help the understanding of the risk of cardiovascular disease and the interaction between genetic and environmental factors. The analysis of these factors may, in the future, enable understanding of the variability of expression of certain environmental factors and help achieve a more global approach to the evaluation of cardiovascular risk. At present, this evaluation of genetic factors of predisposition remains in the field of fundamental research and of clinical and therapeutic trials.