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This Test Does a Better Job Than Genetics at Predicting Risk for Heart Disease in Middle Age

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This could help “calculate risk for heart disease in middle-aged patients when their degree of risk is uncertain or in the intermediate range.”

Despite doctors occasionally overlooking the signs of heart disease, a particular test stands out as the most effective means of identifying individuals at risk of developing this condition. This test can provide valuable insights into the necessary measures that should be taken to mitigate their risk and lower the chances of heart disease occurrence.

According to a recent study conducted by Northwestern Medicine, CT scans are more effective than genetics in predicting the risk of heart disease, including heart attacks, in middle-aged individuals.

Lead study author Dr. Sadiya Khan, an assistant professor of medicine and preventive medicine at Northwestern University Feinberg School of Medicine and a cardiologist at Northwestern Medicine, emphasized the importance of identifying those at risk in order to lower their chances of developing heart disease, the leading cause of death in the United States.

The findings of this study, which will be published today in JAMA, have significant implications for both doctors and patients in managing the risk of heart disease. Currently, doctors rely on traditional risk factors such as blood pressure and cholesterol levels to assess an individual’s likelihood of developing coronary heart disease or arterial blockages. However, these measures may not always detect the risk of heart problems, as some individuals may experience a heart attack without exhibiting these conventional risk factors.

Initially, there was hope that genetics could provide valuable insights into identifying individuals at the highest risk of heart disease since the condition can be hereditary. It was believed that polygenic risk scores, which compile over 6 million common genetic variants associated with heart disease, could serve as a breakthrough in personalized medicine.

However, the Northwestern study directly compared genetics with CT scans for coronary artery calcium and revealed that CT scans outperformed genetics in predicting the risk of heart disease in middle-aged individuals. This finding highlights the superior predictive capabilities of CT scans and their potential to assist doctors and patients in managing and mitigating the risk of heart disease.

“These findings support recommendations to consider CT screening to calculate risk for heart disease in middle-aged patients when their degree of risk is uncertain or in the intermediate range,” said lead study author Dr. Sadiya Khan.

In a comprehensive investigation involving 3,208 adults from two distinct cohort studies—one conducted in the United States and the other in Rotterdam, the Netherlands— the team analyzed crucial data on heart disease risk factors, including smoking status, cholesterol levels, blood pressure, genetics, and CT scan results.

The study, which spanned up to 17 years of follow-up, aimed to estimate individuals’ likelihood of developing heart disease and examine the influence of CT scans and genetic factors on risk prediction, particularly in relation to conventional risk factors such as blood pressure and cholesterol levels.

The researchers found that incorporating genetic data did not result in any significant changes to a person’s risk category based on their conventional risk factors, namely blood pressure and cholesterol levels. However, when the analysis focused solely on CT scan data, it was discovered that approximately half of the study participants were reclassified into a high-risk group.

Risk categories play a crucial role in determining the appropriate preventive measures for heart disease. A low-risk categorization indicates an individual has less than a 7.5% chance of developing heart disease within the next 10 years. On the other hand, if the risk surpasses 7.5%, the recommendation is to consider the use of statins, a type of medication commonly prescribed for managing heart disease.

“The data from the CT scan can help identify individuals who may benefit from medications, such as statins, to reduce their risk of heart disease,” added Khan. 

Image Credit: Getty

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