Genetic map predicts heart disease risk levels for people with type 2 diabetes

Heart Disease Genetics Concept

  • A new study confirmed a risk score based on a map of genetic variants known to affect blood pressure and successfully identified people with type 2 diabetes who are at increased risk of heart attack or stroke.
  • Genetic risk scores, such as the one examined in this study, can help identify risks very early in the disease process and indicate the need for more intensive prevention efforts, such as B. Healthy lifestyle changes in people with type 2 diabetes.

A risk score based on a genetic map predicted the likelihood that high blood pressure would lead to heart problems or stroke in people with type 2 diabetes, according to a study published today in the peer-reviewed journal of the American Heart Association hypertension. This tool can be particularly useful in guiding treatment for people newly diagnosed with type 2 diabetes or for people with pre-diabetes.

Previous research has confirmed that adults with type 2 diabetes are twice as likely to have a heart attack or stroke as people without type 2 diabetes. Various measures of health, such as blood pressure, cholesterol and blood sugar levels, are commonly used to determine a person’s risk of developing heart disease. In this study, researchers looked at whether genetic variants associated with high blood pressure in people with type 2 diabetes were also associated with later heart disease or stroke and used this information to determine a risk score.

“An increased genetic risk of high blood pressure may predispose some people with type 2 diabetes to a higher risk of heart attack, stroke, or cardiovascular death,” said study lead author Pankaj Arora, MD, director of the Cardiogenomics Clinic Program and Cardiology Clinical and Translational Research Program at the University of Alabama at Birmingham. “We conducted the study to determine whether this genetic risk score can identify people with type 2 diabetes who are at higher risk for cardiovascular events, and whether tight blood glucose control could reduce the link between genetic risk of hypertension and cardiovascular consequences.” influenced.”

Arora and colleagues reviewed the medical records of 6,335 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study database for whom genetic data was available. The study group was 37% female and participants self-identified their race or ethnicity: 15% were African American, 6% were Hispanic; 70% were white; and 9% chose the “Other” category. All participants had type 2 diabetes and high blood pressure and were followed for 3.5 years.

A genetic variant map of more than 1,000 common genetic variants known to affect blood pressure was compared to the[{” attribute=””>DNA of the study participants to determine participants’ genetic risk. More matches among the participant’s DNA and the map of known blood pressure genetic variants equated to a higher genetic risk score.

Researchers found that the genetic risk score identified study participants with a higher risk of cardiovascular events:

  • For people with higher than average genetic risk scores, each degree higher was associated with a 12% higher risk of heart disease or stroke events.
  • The association of genetic risk with cardiovascular events was the same even if participants were taking medicines to manage blood sugar levels.

Further evaluation of genetic risk scores in people who do not have Type 2 diabetes is needed to be able to apply these findings more broadly.

Arora and colleagues also noted the findings about differences in individuals’ genetic risk scores for high blood pressure did not entirely explain why intensive glycemic control (aggressive treatment with insulin, medications, diet and exercise) did not appear to have a cardiovascular benefit for people with long-standing Type 2 diabetes.

“However, a genetic risk score maybe helpful for people newly diagnosed with Type 2 diabetes to identify who should have more intense lifestyle changes, such as changes in diet and exercise, and more aggressive management of weight, blood pressure and smoking cessation,” said Arora.

“If you have Type 2 diabetes, there’s a lot you can do to reduce your risk for heart disease,” said Eduardo Sanchez, M.D., M.P.H., FAHA, FAAFP, the American Heart Association’s chief medical officer for prevention, who is the clinical lead for Know Diabetes by Heart, a collaborative initiative between the American Heart Association and the American Diabetes Association addressing the link between diabetes and cardiovascular disease. “In addition to blood sugar control, which is absolutely paramount, we highly encourage people living with Type 2 diabetes to talk with their health care team about other personal and familial risk factors for heart disease or stroke, and what they can do to manage or modify them.”

Reference: 4 April 2022, Hypertension.
DOI: 10.1161/HYPERTENSIONAHA.122.18976

Co-authors include Vibhu Parcha, M.D.; Akhil Pampana, M.S.; Adam Bress, Pharm.D., M.S.; Marguerite R. Irvin, Ph.D.; and Garima Arora, M.D. The authors’ disclosures are listed in the manuscript. Genetic map predicts heart disease risk levels for people with type 2 diabetes

Russell Falcon

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