New tool to identify people at risk of coronary heart disease

21 September 2016        

A lab test

New 'genetic risk scores' could pave the way for earlier intervention and lifestyle changes to prevent heart attacks, thanks to research part-funded by us.

Researchers around the world, including BHF Professor Sir Nilesh Samani at the University of Leicester have developed a new scoring system, known as a 'genomic risk score' (GRS) which could help to identify individuals at risk of coronary heart disease much earlier, and potentially improve its prevention. 

Coronary heart disease affects over 2.3 million people in the UK and the disease is responsible for nearly 70,000 deaths in the UK each year – most caused by a heart attack.

Genes and heart disease

Genetic factors have been long known to make a significant contribution to coronary heart disease risk. Recent advances in genetics have led to the identification of many Single Nucleotide Polymorphisms, or SNPs – very small differences in our DNA that vary from person to person.

Risk scoring

The researchers looked at over 49,000 SNPs and showed that the higher the GRS the higher the future risk of CHD. People with a GRS in the top 20 per cent had an over 5-fold higher lifetime risk of coronary heart disease than those in the bottom 20 per cent. 

This study, published in the European Heart Journal is the first to look at a much larger number of SNPs to give a fuller picture of an individual's genetic risk of developing CHD.

What we do now

Currently, clinical risk scores are based on known risk factors for CHD such as cholesterol level, having high blood pressure or diabetes, and smoking. But such scores are imprecise and unable to identify a large proportion of people who develop CHD.

By combining the GRS with the existing clinical risk scores, the researchers were better able to predict people who were at risk of developing CHD in the next 10 years.

Identifying risk earlier

BHF Professor Sir Nilesh Samani, an author on the paper who has co-led the discovery of many of the genes associated with coronary heart disease, said:

"We already know that CHD starts at an early age, several decades before symptoms develop, and preventative measures should ideally be applied much earlier, especially to those who are at increased risk. 

"Unfortunately, current clinical risk scores are not good at evaluating risk until middle-age. On the  hand the GRS, which is based on your DNA, can be applied at any age. Further studies are needed to demonstrate the precise clinical value of this approach in different populations. However earlier identification of people who would most benefit from lifestyle changes and medication to reduce their risk of a heart attack could save countless lives."

Making changes to reduce risk

It's important to remember that having a genetic predisposition to coronary heart disease does not guarantee that a person will have a heart attack. Thanks to research, much of it funded by us, people identified as being at increased risk can reduce their chances of having a heart attack by stopping smoking, exercising regularly, managing their weight and taking prescribed medication, such as a statin.

Find out more about our research

We are the major funder of cardiovascular research at UK universities and hospitals. Thanks to the generosity of the public we fund around £100 million of research each year.

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