Over the last decade, much has been learned about the genetic risk factors for cardiovascular disease. In the long run, as researchers uncover how variations in these genes lead to heart disease, this knowledge may lead to new preventive drugs and treatments. But in the meantime, doctors have been uncertain about how to use this information in their clinical practice.
Can simply disclosing a patient’s genetic risk of heart disease can affect outcomes? New research presented as a late-breaking clinical trial at the AHA 2015 conference suggests that it can, by motivating patients to start preventive medication.
Iftikhar Kullo, MD, and his colleagues at the Mayo Clinic looked at whether telling patients their genetic risk score, derived from 28 genetic variants not related to blood pressure or lipids, could help lower levels of LDL cholesterol. The 207 patients enrolled in their MI-GENES randomized trial were between 45 and 65 years of age, at intermediate risk of heart disease, and were not taking statins.
Of those patients, half received a risk estimate based on conventional risk factors alone, and half received both conventional and genetic risk information. Genetic risk was explained during a session with a genetic counsellor, and decisions about prevention—such as starting a statin or making lifestyle changes—were made collaboratively with a physician.
Six months later, participants who received both genetic and conventional risk estimates had significantly lower LDL levels than those who received a conventional risk estimate alone. This result was true for people at both high and low genetic risk.
Participants receiving their genetic risk score were more likely to be taking a statin six months after the start of the study (39% versus 22%). The researchers did not see any significant changes in dietary fat intake, physical activity levels, or anxiety between the two groups.
Though additional studies are needed for individuals of non-European ancestry, the results suggest that “genetic risk information can be effectively used at the point of care to guide therapy,” said Dr. Kullo at the November conference.