Article Text

Download PDFPDF
Polygenic risk, lifestyle and the lifetime risk of coronary artery disease
  1. Paul S de Vries
  1. Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  1. Correspondence to Dr Paul S de Vries, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Paul.S.DeVries{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Genome-wide association studies (GWASs) including hundreds of thousands of individuals have characterised the coronary artery disease (CAD) risk associated with millions of genetic variants that are common in the population.1 Polygenic risk scores (PRSs) for CAD summarise the risk of CAD conferred by these genetic variants into a single score. While each genetic variant only confers a modest increase in the risk of CAD, when taken together in the form of a PRS, they show a strong and robust association with incident CAD events that are largely independent of traditional risk factors and family history.2 One distinct advantage of PRSs is they can be measured early in life, prior to the accumulated effects of traditional risk factors and before there is evidence of family history for CAD, allowing for the possibility of early intervention in very high-risk individuals.

PRSs only appear to confer modest improvements in risk prediction beyond established non-genetic risk scores, with unclear clinical significance.2 3 Nevertheless, PRSs can identify a subset of the population with a high polygenic risk that is equivalent to the risk from familial hypercholesterolaemia mutations.4 Many countries implement cascade screening programmes for the identification of patients with familial hypercholesterolaemia, who then undergo early and intensive preventive interventions to lower their risk. In contrast, individuals with high polygenic risk are not identified and are not offered the same opportunities to become aware of and intervene on their risk.

While the clinical utility of PRSs thus remains to be firmly established, they have undoubtedly served as useful research tools, enabling the investigation of a range of research questions. Among these, one emerging area of research is the interplay between lifestyle …

View Full Text


  • Contributors PdV conceived of, wrote and revised this editorial.

  • Funding PdV was funded by the National Heart, Lung, and Blood Institute (grant number R01HL146860).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

  • Coronary artery disease
    Qingmei Cui Zhongying Liu Jianxin Li Fangchao Liu Xiaoge Niu Chong Shen Dongsheng Hu Keyong Huang Shufeng Chen Yingxin Zhao Fanghong Lu Xiaoqing Liu Jie Cao Laiyuan Wang Hongxia Ma Ling Yu Xianping Wu Ying Li Huan Zhang Xingbo Mo Liancheng Zhao Zhibin Hu Hongbing Shen Jianfeng Huang Xiangfeng Lu Dongfeng Gu