Print Share Email Send Email Your Name (required) Example: John Doe This field is required. Email Address (required) Error: Please enter a valid sender email address. Example: firstname.lastname@example.org CC Me This field is required. Please enter a valid email address. Recipient Email Address(es) (required - use a semicolon to separate multiple addresses) Separate multiple email address with semi-colons (up to 5). This field is required. Please enter a valid email address. One or more of your email addresses are invalid. Please review before submitting. Subject Subject for your email. Message (Maximum characters: 1,000) Thank you! Your email has been sent to: The recipient(s) will receive an email message that includes a link to the selected article. Recipients may need to check their spam filters or confirm that the address is safe. Return to: Send Another Email An error has occurred sending your email(s). Please try again later or contact an administrator at OnlineCustomer_Service@email.mheducation.com. Return to: Twitter Facebook Linkedin Reddit Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Healy M, Kadian-Dodov D. Healy M, & Kadian-Dodov D Healy, Michael, and Daniella Kadian-Dodov. Lifelong Exposure to Genetic Variants for Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure Reduces Lifetime Risk of Cardiovascular Disease. Hurst's the Heart Updates, 16 October 2019. McGraw-Hill, 2019. AccessCardiology. https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506584§ionid=229608417APA Citation Healy M, Kadian-Dodov D. Healy M, & Kadian-Dodov D Healy, Michael, and Daniella Kadian-Dodov. (2019). Lifelong exposure to genetic variants for lower low-density lipoproteins and lower systolic blood pressure reduces lifetime risk of cardiovascular disease. Fuster V. Fuster V Fuster, Valentin. Hurst's the heart updates. McGraw-Hill. https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506584§ionid=229608417.MLA Citation Healy M, Kadian-Dodov D. Healy M, & Kadian-Dodov D Healy, Michael, and Daniella Kadian-Dodov. "Lifelong Exposure to Genetic Variants for Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure Reduces Lifetime Risk of Cardiovascular Disease." Hurst's the Heart Updates Fuster V. Fuster V Fuster, Valentin. McGraw-Hill, 2019, https://accesscardiology.mhmedical.com/updatesContent.aspx?gbosid=506584§ionid=229608417. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Tools Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Lifelong Exposure to Genetic Variants for Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure Reduces Lifetime Risk of Cardiovascular Disease by Michael Healy, Daniella Kadian-Dodov Listen + +Update to Chapter 25: Diagnosis and Treatment of Hypertension, and Chapter 29: Hyperlipidemia Study Summary + +This study explored the association between lifetime exposure to lower LDL-C and lower systolic BP (SBP) with lifetime risk of CVD. Genetic LDL-C and SBP scores were derived from exome variants of 438,953 participants enrolled in the UK Biobank between 2006 and 2010 and followed-up until 2018. The scores were used to divide participants into groups with lifetime exposures to lower LDL-C, lower SBP, or both. Differences between groups were compared with estimate association with lifetime risk of CVD. The main outcome was the OR for MACE. Participants with LDL-C genetic scores above the median had 14.7 mg/dl lower LDL-C and an OR of 0.73 for MCE (P < 0.001). Participants with SBP genetic scores above the median had 2.9 mmHg lower SBP and an OR of 0.82 for MACE (P < 0.001). Participants in the group with both genetic scores above the median had an OR of 0.61 for MACE (P < 0.001). Exposure to increasingly low LDL-C and SBP combinations was associated with a dose-dependent reduction in the risk of MACE, and combined exposure lower LDL-C and SBP was associated with a 78% lower lifetime cardiovascular risk (OR 0.22; P < 0.001). Commentary + +Study Strengths: This study extends the results of previous studies by demonstrating that combined exposure to both lower LDL-C and lower SBP is associated with a lower risk of CVD that is additive and dose-dependent. The use of Mendelian randomization using genetic variants is less susceptible to confounding than prospective cohort studies and helps elucidate an important issue that would otherwise require a large, randomized controlled trial spanning several decades. +Study Limitations: The study did not address whether lowering LDL-C or SBP through medications or other interventions would result in the same outcomes associated with the genetic variants of lower LDL-C or SBP. +Next Steps/Clinical Perspective: Lifelong genetic exposure to lower levels of LDL-C and lower SBP was associated with lower cardiovascular risk. Early screening for elevated LDL-C and SBP could provide an opportunity to prevent CVD. Study Reference + + + +Ference BA, Bhatt DL, Catapano AL, et al. Association of Genetic Variants Related to Combined Exposure to Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure With Lifetime Risk of Cardiovascular Disease. JAMA[JAMA and JAMA Network Journals Full Text] doi: 10.1001/jama.2019.14120.