Genetic Heart Disease Risk Eased by Healthy Habits, Study Finds

By Gina Kolata, NY Times, Nov. 13, 2016

Is genetics destiny when it comes to heart disease?

A new analysis of data from more than 55,000 people provides an answer. It finds that by living right–by not smoking, by exercising moderately and by eating a healthy diet heavy in fruits, vegetables and grains–people can tamp down even the worst genetic risk.

“DNA is not destiny; it is not deterministic for this disease,” said Dr. Sekar Kathiresan, the director of the Center for Human Genetic Research at Massachusetts General Hospital. “You do have control over the problem, even if you have been dealt a bad genetic hand.”

The research, by Dr. Kathiresan and his colleagues, is the first attempt to use large data sets to tease apart the effects of genes and lifestyle in heart disease, researchers said. It was published on Sunday in The New England Journal of Medicine to coincide with the presentation of the results at the annual meeting of the American Heart Association.

About 365,000 people die of coronary heart disease–the most common type–annually in the United States, and 17.3 million worldwide, making it one of the biggest killers.

The investigators found that genes can double the risk of heart disease, but a good lifestyle cuts it in half. Just as important, they found, a terrible lifestyle erases about half of the benefits of good genetics.

According to Dr. Lawrence J. Appel, the director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions, you do not have to have an exemplary lifestyle to reap a big benefit. It looks as if the biggest protective effect by far came from going from a terrible lifestyle to one that was at least moderately good.

The new study shows a new way to think about genes and lifestyle, researchers say.

“It’s very important,” said Dr. David Maron, the director of preventive cardiology at Stanford, who was not involved in the new study. “If you are dealt a bad hand, there are things you can do to attenuate the risk.”

Dr. Kathiresan is already using the study’s results when he sees patients, he said. The genetic test is not available outside of research studies, he said, but he often gets an idea of who has a worrisome genetic risk when he talks to patients.

“A poor man’s substitute,” he said, “is: ‘My dad died at 45 of a heart attack. I have a strong family history.’”

He now replies, “You have it in your power to change that risk.”

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Fatal Heart Attacks Occur On Christmas More Than Any Other Day

CBS 11 News, December 18, 2014

NORTH TEXAS—It’s become the norm for many of us: harried, hurried, and just plain old stressed!

“We drive ourselves very heavily in our society,” says Mark Gross of Grapevine. “No doubt about it. But, there is a cost. There is a cost.”

Mark very nearly paid with his life. “I felt it. I felt the aortic dissection rip through my chest,” he recalled.

It was February of 2012 and Mark says he can remember the moment when he felt the largest artery in his body—battered by high blood pressure and chronic stress—tear. “I said, ‘it may be all over with, and I was preparing to lay back on the bed and die. Literally.”

Mark was eventually taken by air ambulance to Baylor’s Heart Hospital Plano where he spent five weeks in a coma. That was followed by 12 weeks of rehabilitation to re-learn how to walk. It was a stark contrast to the active lifestyle he’d previously led—white water rafting, zip-lining and enjoying the outdoors.

“I’m just a regular guy. [I] let my blood pressure get out of control with the stress and kerboom! Here it happened.”

According to the Centers for Disease Control, high blood pressure affects one in three Americans. Add on chronic stress, and experts say there’s a reason that high blood pressure is called the silent killer.

“You can have it and have virtually no symptoms and not really know it—not recognize it,” says David Brown, MD, at cardiologist at the Heart Hospital Baylor Plano. “It’s a big deal.”

According to Dr. Brown, “it can cause heart disease, heart attacks. It causes disease in the brain that leads to stroke. It causes kidney disease that leads to kidney failure that leads to dialysis. The list goes on.”

But, not for Mark Gross. He says he walked away from the high stress job and is now more deliberate about managing his blood pressure—and his stress. He has learned the hard way to not take life for granted. “No,” he reiterates, “I don’t take it for granted at all.”

Mark says his story is also a cautionary tale for those tempted to take stress in stride…especially during the holidays.

Researchers, more than a decade ago, found that more fatal heart attacks occur on Christmas Day than any other day of the year. The 2nd busiest day is December 26th and the 3rd busiest is January 1st.

The pattern has continued for so long that health care workers coined the term “Christmas Coronary.”

Mark has decided to pass on the lethal package—gifting himself and his family with lifestyle choices that support heart health. “So the quality of life is a lot better.”

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