Are genetics destiny when it comes to coronary disease? The answer may give strength to the benefits of a well-run workplace wellness program — and how it is designed.
Certainly, genetics matter. As the New England Journal of Medicine reported last year in a study titled Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease, “Both genetic and lifestyle factors are key drivers of coronary artery disease, a complex disorder that is the leading cause of death worldwide. A familial pattern in the risk of coronary artery disease was first described in 1938 and was subsequently confirmed in large studies involving twins and prospective cohorts. Since 2007, genomewide association analyses have identified more than 50 independent loci associated with the risk of coronary artery disease. These risk alleles, when aggregated into a polygenic risk score, are predictive of incident coronary events and provide a continuous and quantitative measure of genetic susceptibility.”
However, simultaneously, “much evidence has also shown that persons who adhere to a healthy lifestyle have markedly reduced rates of incident cardiovascular events. The promotion of healthy lifestyle behaviors, which include not smoking, avoiding obesity, regular physical activity, and a healthy diet pattern, underlies the current strategy to improve cardiovascular health in the general population.”
So the researchers looked at the balance of genetics and healthy lifestyle: “Many observers assume that a genetic predisposition to coronary artery disease is deterministic. However, genetic risk might be attenuated by a favorable lifestyle. Here, we analyzed data for participants in three prospective cohorts and one cross-sectional study to test the hypothesis that both genetic factors and baseline adherence to a healthy lifestyle contribute independently to the risk of incident coronary events and the prevalent subclinical burden of atherosclerosis. We then determined the extent to which a healthy lifestyle is associated with a reduced risk of coronary artery disease among participants with a high genetic risk.”
The conclusion is supportive — even in the face of challenging genetics — of a healthy lifestyle, which is central to a well run workplace wellness program.
Indeed, we previously reported how exercise and diet are beneficial, even for people with genetic obesity risk.
The NEJM study concludes: “Within any genetic risk category, adherence to a healthy lifestyle was associated with a significantly decreased risk of both clinical coronary events and subclinical burden of coronary artery disease.”
It outlines three conclusions:
- “Inherited DNA variation and lifestyle factors contribute independently to a susceptibility to coronary artery disease.”
- “A healthy lifestyle was associated with similar relative risk reductions in event rates across each stratum of genetic risk.”
- “Patients may equate DNA-based risk estimates with determinism, a perceived lack of control over the ability to improve outcomes. However, our results provide evidence that lifestyle factors may powerfully modify risk regardless of the patient’s genetic risk profile.”