Fitness and Genetic Risk for CV Disease

Apr 17, 2018
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Authors:
Tikkanen E, Gustafsson S, Ingelsson E.
Citation:
Associations of Fitness, Physical Activity, Strength, and Genetic Risk With Cardiovascular Disease: Longitudinal Analyses in the UK Biobank Study. Circulation 2018;Apr 9:[Epub ahead of print].
Summary By:
Daniel T. Eitzman, MD

Study Questions:

Do strength and fitness associate with lower cardiovascular (CV) events even in patients with elevated genetic risk?

Methods:

Estimates of physical activity, strength, and fitness were correlated with CV events and death over a 6.1-year follow-up period in half a million individuals. Correlations were also made as a function of genetic risk scores for coronary heart disease (CHD) and atrial fibrillation.

Results:

Measures of grip strength, physical activity, and fitness were all associated with reduced incidence of CHD events with hazard ratios (HRs) of 0.79, 0.95, and 0.68, per standard deviation [SD] change, respectively, and also with reduced incidence of atrial fibrillation (HRs of 0.75, 0.93, and 0.60, per SD change, respectively). Inverse associations for grip strength and fitness level were maintained even in the setting of a high genetic risk score for these diseases with a HR of 0.51 for CHD and 0.40 for atrial fibrillation.

Conclusions:

Physical activity, strength, and fitness are inversely associated with CV disease in the general population and those with high CV genetic risk.

Perspective:

This large study provides impressive confirmatory data regarding the potential effects of activity, fitness, and strength towards reduced CHD events. Associations with reduced incidence of atrial fibrillation are particularly impressive considering previous controversy in this area. Importantly, this study provides hope even for patients at high genetic risk for these diseases, as this risk may be markedly attenuated with adjustments in lifestyle.

Clinical Topics: Acute Coronary Syndromes, Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Implantable Devices, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Exercise

Keywords: Acute Coronary Syndrome, Arrhythmias, Cardiac, Atrial Fibrillation, Coronary Disease, Exercise, Genetics, Hand Strength, Life Style, Metabolic Syndrome, Muscle Strength, Physical Fitness, Primary Prevention, Risk Factors, Vascular Diseases


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