A study of nearly 450,000 participants from the UK suggests lifelong genetic exposure to lower levels of LDL-C coupled with lower systolic blood pressure (SBP) is associated with lower cardiovascular risk. The findings were presented on Sept. 2 as part of ESC Congress 2019 and published in the Journal of the American Medical Association.

Brian A. Ference, MD, MPhil, MSc, FACC, and Deepak L. Bhatt, MD, MPH, FACC, et al., used genetic LDL-C and SBP scores to divide participants into three groups: lifetime exposure to lower LDL-C, lower SBP, or both. Participants ranged from 40 to 80 years of age, with a median age of 65.2 years, and more than half (54.1 percent) were women. Differences in plasma LDL-C, SBP and cardiovascular event rates were then compared between the groups to estimate associations with lifetime cardiovascular disease risks.

Overall results showed participants with LDL-C genetic scores higher than the median had lower LDL-C levels (by 14.7 mg/dL) and an odds ratio (OR) of 0.73 for major coronary events. Similarly, participants with SBP genetic scores higher than the median had lower SBP (by 2.9 mm Hg) and an OR of 0.82 for major coronary events. Participants in the group with both genetic scores higher than the median had LDL-C that was lower by 13.9 mg/dL, SBP that was lower by 3.1 mm Hg and an OR of 0.61 for major coronary events. Additional analysis showed exposure to increasing genetic risk scores and lower LDL-C levels and SBP was associated with dose-dependent lower risks of major coronary events, Ference and colleagues said.

While the findings are positive, the researchers caution that they "cannot be assumed to represent the magnitude of benefit achievable from treatment of these risk factors."

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Stable Ischemic Heart Disease, Hypertension, Chronic Angina

Keywords: ESC 19, ESC Congress, Hypertension, Dyslipidemias, Primary Prevention, Angina, Stable

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