One of the key, non -modified risk factors for cardiovascular disease is genetic predisposition. If the risk is recognized in time, more targeted prevention strategies can be implemented.
In people who do not have traditional risk factors for cardiovascular disease, genetic information may reveal a “silent” predisposition, which would otherwise remain unknown to the appearance of a heart attack for example.
The President of the Hellenic Cardiology Society of Constantine Toutouzas, Professor of Cardiology of the NCSR, First Cardiology Clinic, Hippocrates GNA, Head of Structural Heart Press, Valve Diseases and Cardio-Oncology, Chairman Elect Council for Cardiology cardiovascular disease.
How strong is heredity in cardiovascular disease? Which is more important than the lifestyle?
Inheritance is one of the main non -modified risk factors for cardiovascular disease. In diseases such as premature coronary heart disease, hypertension or hereditary forms of hyperlipidemia, the genetic factor is of particularly important importance and may prevail over environmental factors.
However, in most cases, cardiovascular disease is the result of the interaction of genes and the environment – that is, genetic predisposition combined with lifestyle. We are not talking about “fate”, but of predisposition, which is influenced and shaped by our choices.
Why is it important to know his genetic predisposition to the development of cardiovascular disease?
Early recognition of individual risk – including genetic – allows us to implement more targeted prevention strategies. Particularly in people who do not have traditional risk factors, genetic information may reveal a “silent” predisposition that would otherwise remain unknown until the appearance of an acute event, such as a heart attack.
In such cases, the utilization of genetic information can guide the intensity and frequency of preventive monitoring.
What is a Polygystal Risk (PRS) rating and how is the examination for it? What does it serve?
The Polygenic Risk Score (PRS) is a tool that appreciates the overall genetic risk of a person based on the accumulation of common genetic polymorphisms associated with the onset of a disease. The analysis is carried out through a simple saliva sampling and the results can give an assessment of the “registered” risk that the person carries on his DNA.
The PRS is not used diagnostics, but predictions – provides a risk assessment that can be used in making precautionary decisions, enhancing the concept of personalized medicine.
How worrying is a high PRS rating?
A high PRS score does not mean that one will definitely develop heart disease. It means, however, that this person is statistically more likely to develop the disease at some stage of their life than the general population.
It is an independent risk indicator, which is added to the classic factors (such as hypertension, dyslipidemia, smoking). The important thing is that this information can lead to earlier intervention – either by lifestyle changes or by pharmacological prevention where appropriate. Therefore, the PRS is not a source of concern, but a tool for enhancing prognosis.
What cardiovascular diseases can be detected with the rating of polygenic risk?
The PRS has so far been mainly evaluated for coronary heart disease and stroke, providing significant predictive value, regardless of classical risk factors. At the same time, it is supported by its use by numerous bibliographic references to other cardiovascular disease, such as atrial fibrillation, heart failure and some forms of cardiomyopathies.
It is particularly useful in primary prevention, that is, to identify people who have not yet had symptoms but have a high genetic load.
Can the lifestyle and/or preventive medication defeat heredity?
There is strong indications that a healthy lifestyle can significantly reduce the absolute cardiovascular risk, even in people with high genetic load. Recent studies have shown that people with increased polygenic risk (PRSs), who systematically adopt healthy habits – such as proper nutrition, regular physical activity and smoking avoidance – have a significantly lower risk of cardiovascular disease than low -life.
With regard to medication, it is not administered preventively but is applied following clinical indications and in accordance with applicable guidelines. However, in people with a detected inheritance burden, it is important to intensify the frequency of medical monitoring in order to identify early changes that may require pharmaceutical intervention.
It is also important to emphasize that the treating physicians are required for these individuals to be particularly strict in achieving therapeutic goals for the regulation of risk factors – such as blood pressure, lipids and sugar.
Therefore, knowledge of a person’s genetic predisposition is necessary because it is a part of the puzzle of cardiovascular health. Prevention is now an option.
How can one learn his genetic predisposition? Is there any genetic examination in Greece?
Access is now very easy and simple in our country. There is a certified in vitro diagnostic test (CEIVD) by making genetic analysis to calculate PRS accessible to pharmacies and selected diagnostic centers.
The process is simple and easy, only with a saliva sample that makes it quick and friendly to the examiner. It is a technology that until recently was only available abroad, but is now available in Greece, giving each interested party and their doctor the ability to personalize genetic predisposition to follow the appropriate prevention program for cardiovascular health.