Said MA, et al. - In a large contemporary population, researchers looked at how combined health behaviors and factors within genetic risk groups correlated with coronary artery disease, atrial fibrillation, stroke, hypertension, and type 2 diabetes. They also determined the interactions between genetic risk and lifestyle. Findings showed a log-additive impact of genetic composition and combined health behaviors and factors on the risk of developing cardiovascular disease. Genetic risk groups exhibited comparable relative effects of poor lifestyle. Via comprehensive, multifactorial approaches, behavioral lifestyle changes should be encouraged in all patients, although high-risk individuals may be selected based on the genetic risk.

Methods

• This study included 339,003 unrelated individuals of white British descent with available genotype and matching genetic data and reported sex from the UK Biobank cohort study, which includes more than 500,000 participants aged 40 to 70 years who were recruited from 22 assessment centers across the UK from 2006 to 2010.
• Individuals were included in the analyses of one or more new-onset diseases.
• From April 2006 to March 2015, data analysis was carried out.
• Main outcomes and measures included risks of new-onset cardiovascular disease and diabetes associated with genetic risk and combined health behaviors and factors.
• Categories of genetic risk were low (quintile 1), intermediate (quintiles 2-4), or high (quintile 5).
• Researchers investigated the risks of incident events associated with ideal, intermediate, or poor combined health behaviors and factors within each genetic risk group, and compared with low genetic risk and ideal lifestyle.

Results

• A total of 339,003 individuals were included, with 181,702 (53.6%) being female, and mean (SD) age being 56.86 (7.99) years.
• During follow-up, development of coronary artery disease was reported in 9,771 of 325,133 participants (3.0%), atrial fibrillation in 7,095 of 333,637 (2.1%), stroke in 3,145 of 332,971 (0.9%), hypertension in 11,358 of 234,651 (4.8%), and diabetes in 4,379 of 322,014 (1.4%) participants.
• Findings revealed association of poor lifestyle with a hazard ratio of up to 4.54 (95% CI, 3.72-5.54) for coronary artery disease, 5.41 (95% CI, 4.29-6.81) for atrial fibrillation, 4.68 (95% CI, 3.85-5.69) for hypertension, 2.26 (95% CI, 1.63-3.14) for stroke, and 15.46 (95% CI, 10.82-22.08) for diabetes in the high genetic risk group vs ideal lifestyle in the low genetic risk group.