Genes can define treatment regimes for cardiovascular risk

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Screening for a specific genetic variation can identify which patients are in greatest need of primary prevention for cardiovascular disease, US research suggests.

The importance of the common DNA variation in the 9p21 chromosomal was highlighted by researchers this week at an American Heart Association conference in New Orleans.

'We already know that 9p21 DNA variation is associated with a greater risk of heart events, but now we have shown its direct usefulness to patient care by adding it to traditional risk factor measurements,' said lead author Ariel Brautbar, clinical postdoctoral fellow in molecular and human genetics at Baylor College of Medicine in Houston

The researchers tested 10,000 middle-aged patients already taking part in study on the causes of atherosclerosis to identify those with a variation in 9p21. Subjects had already been categorised into high, intermediate and low risk – based on traditional cardiovascular risk factors. 

However, the authors found that, based on the presence of the genetic variation, many of those who were found to have a higher risk than previously thought. As a result, nearly 20% in the low risk range and 16% in the intermediate risk range had to be recategorised.

'A person at high risk will be treated aggressively, regardless of whether he or she has this variation. A low-risk person with good health won't be treated differently either,' Dr Brautbar said. 'However, someone in the intermediate risk group could be moved into a higher or lower risk category, depending on whether he or she has the genetic variant. This, in turn, could affect how he or she is treated.'