Genetic makeup is one of the most important factors when assessing an individual’s likelihood of heart disease. If a first degree relative (e.g., someone in your immediate family) died before the age of 75, from a heart attack or heart related disease, that should trigger a warning that you may have inherited faulty genes. These genes can predispose you to increased risk of coronary disease. You can’t choose your parents!
Understanding your genetic risk
As we all know, our genes come from our parents. Half of our genes are from our mother and half are from our father.
We also share genetic information with our siblings and cousins. How can understanding our genetics better help us to reduce the risk of heart related illnesses? Our bodies are made up almost entirely of proteins. Those proteins are coded using our genetic information. If you inherit faulty genes, this can lead to faults in your proteome (the set of proteins produced by your cells). This can cause mutations at the protein level. Companies like SomaLogic are leading the charge in this area. Mutations at the protein level precede diseases such as atherosclerosis and blood clotting disorders. High cholesterol, high blood pressure and inefficient fat storing capabilities are all manifestations of genetic, proteomic and metabolomic abnormalities. If we could identify those protein abnormalities at a very early stage, then we could take some steps to try and prevent heart diseases before an individual has symptoms, reducing the strain on the NHS and saving lives.
Polygenic Risk Score: a nod to the future
Tests such as those at 23andme and Rightangled give you information on how your genes can affect your health: your predisposition to certain diseases such as cancer and diabetes. They can identify markers in your DNA that increase or decrease your chance of developing cardiovascular disease. The polygenic risk score takes this concept further by identifying genetic changes that, coupled with environmental factors, can lead to any number of diseases or conditions. Currently, this risk score is not routinely used by healthcare professionals, as it is still relatively new, and researchers are working to improve the scoring.
In the future, scores such as the polygenic risk score may allow us to understand our proteomes and genomes at a younger age, enabling us to advise people accurately on the lifestyle factors that are going to have the most beneficial impact on our health. For example, a polygenic risk score may be able to tell us that an individual is particularly susceptible to harmful inflammation from eating red meat or certain grains and they would be wise to cut back on these. Whereas another person might be particularly likely to benefit from a certain kind of diet or exercise regime, such as strength training and weights for example.
In the future, this information should allow doctors to develop a bespoke plan in line with your genes, preventing disease and giving you the information you need to make the best healthcare decisions.
Your DNA is very important and at some point, soon it will play an even bigger part in informing our decisions. However, even now, your DNA does not have to be your destiny. Studies from the Massachusetts General Hospital have proven that even if you’ve inherited a bad hand, genetically, your lifestyle choices can reduce your risk of heart disease by up to 50%. We may not know exactly which dietary changes and exercise types are going to have the most impact on reducing risk, but we do know that reducing your exposure (changing your exposome!) by quitting smoking, reducing alcohol intake, increasing your physical exercise and maintaining a healthy diet are all important factors that can reduce your future risk of cardiovascular disease.
For more information on heart screening click here
