RT Journal Article
SR Electronic
T1 Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2022-321657
DO 10.1136/heartjnl-2022-321657
A1 Qingmei Cui
A1 Zhongying Liu
A1 Jianxin Li
A1 Fangchao Liu
A1 Xiaoge Niu
A1 Chong Shen
A1 Dongsheng Hu
A1 Keyong Huang
A1 Shufeng Chen
A1 Yingxin Zhao
A1 Fanghong Lu
A1 Xiaoqing Liu
A1 Jie Cao
A1 Laiyuan Wang
A1 Hongxia Ma
A1 Ling Yu
A1 Xianping Wu
A1 Ying Li
A1 Huan Zhang
A1 Xingbo Mo
A1 Liancheng Zhao
A1 Zhibin Hu
A1 Hongbing Shen
A1 Jianfeng Huang
A1 Xiangfeng Lu
A1 Dongfeng Gu
YR 2022
UL http://heart.bmj.com/content/early/2023/02/02/heartjnl-2022-321657.abstract
AB Objective To examine whether adherence to ideal cardiovascular health (CVH) can mitigate the genetic risk of coronary artery disease (CAD) in non-European populations.Methods Fine and Grey’s models were used to calculate HRs and their corresponding 95% CIs, as well as the lifetime risk of CVH metrics across Polygenic Risk Score (PRS) categories.Results We included 39 755 individuals aged 30–75 years in Chinese prospective cohorts. 1275 CAD cases were recorded over a mean follow-up of 12.9 years. Compared with unfavourable CVH profile (zero to three ideal CVH metrics), favourable CVH profile (six to seven ideal CVH metrics) demonstrated similar relative effects across PRS categories, with the HRs of 0.40 (95% CI 0.24 to 0.67), 0.41 (95% CI 0.32 to 0.52) and 0.36 (95% CI 0.26 to 0.52) in low (bottom quintile of PRS), intermediate (two to four quintiles of PRS) and high (top quintile of PRS) PRS categories, respectively. For the absolute risk reduction (ARR), individuals with high PRS achieved the greatest benefit from favourable CVH, mitigating the risk to the average level of population (from 21.1% to 8.7%), and the gradient was strengthened in individuals at the top 5% of PRS. Moreover, compared with individuals at low PRS, those at high PRS obtained longer CAD-free years (2.6 vs 1.1) from favourable CVH at the index age of 35 years.Conclusion Favourable CVH profile reduced the CAD relative risk by similar magnitude across PRS categories, while the ARR from favourable CVH was most pronounced in high PRS category. Attaining favourable CVH should be encouraged for all individuals, especially in individuals with high genetic susceptibility.Data are available upon reasonable request.