Int J Family Med Prim Care | Volume 3, Issue 1 | Review Article | Open Access
Robert Roberts1*, Judith Chavira2 and Esperanza Acuna3
1Department of Medicine, University of Arizona, USA 2Biological Sciences/Kinesiology, USA 3Bachelors of Science in Physiology, USA
*Correspondance to: Robert RobertsFulltext PDF
CAD, most common cause of death worldwide affects 50% of all Americans. CAD initiates early and slowly develops with clinical manifestations decades later. Primary prevention is most effective if initiated early. Conventional risk factors for CAD are often not present until the 5th or 6th decade too late for primary prevention. 50% of the risk for CAD is genetic. Recent discovery of 200 genetic risk variants enables one to estimate the genetic accumulative risk for CAD in a single number referred to as Polygenic Risk Score (PRS). Retrospective risk stratification with the PRS in clinical trials that evaluate the effect of drugs on cardiac mortality by lowering plasma cholesterol show individuals with the highest PRS have the highest risk for CAD and the most benefit from decreasing plasma LDL-C. The PRS has been evaluated in over 1 million individuals and those with the highest PRS (10% to 20%) have 1 to 4 fold increased risk for CAD. Prospective studies based on risk stratification by the PRS show a favorable lifestyle reduces genetic risk for CAD by nearly 50% in those with the highest PRS, and similar results are observed for physical fitness. The PRS, determined at conception, does not change throughout one’s lifetime and so can be estimated at birth or anytime thereafter. Incorporation of the PRS (inexpensive and accessible) into routine clinical practice would be a paradigm shift in the prevention of this pandemic disease
Roberts R, Chavira J, Acuna E. Therapeutic Implications of Genetic Risk Stratification for CAD. Int J Fam Med Prim Care. 2022; 3(1): 1059..