11 causal risk factors for CVD that can be modified

A systematic Mendelian randomization (MR) study has identified several modifiable cardiovascular disease (CVD) causal risk factors, including hypertension, smoking, and high body mass index (BMI).

Researchers identified instruments for 15 modifiable CVD risk factors from previously published genome-wide association studies (GWAS) for blood pressure (BP), glucose, lipids, overweight, smoking, alcohol intake, sedentariness, and education.

A large GWAS—which involved 60,801 coronary artery disease (CAD) patients and 123,504 controls and 40,585 ischaemic stroke patients and 406,111 controls—was used to extract the effects of the genetic variants used as instruments for the exposures on CAD and ischaemic stroke (IS).

Data revealed the following factors to be causally related to CVD: genetically predicted hypertension (CAD: odds ratio [OR], 5.19, 95 percent confidence interval [CI], 4.21–6.41; IS: OR, 4.92, 95 percent CI, 4.12–5.86), systolic BP (CAD: OR, 1.03 95 percent CI, 1.03-1.04; IS: OR, 1.03, 95 percent CI, 1.03–1.03), diastolic BP (CAD: OR, 1.05, 95 percent CI, 1.05–1.06; IS: OR, 1.05, 95 percent CI, 1.04–1.05), smoking initiation (CAD: OR, 1.26, 95 percent CI, 1.18–1.35; IS: OR, 1.24, 95 percent CI, 1.16–1.33), educational attainment (CAD: OR, 0.62, 95 percent CI, 0.58–0.66; IS: OR, 0.68, 95 percent CI, 0.63–0.72), type 2 diabetes (CAD: OR, 1.11, 95 percent CI, 1.08–1.15), low-density lipoprotein cholesterol (CAD: OR, 1.55, 95 percent CI, 1.41–1.71), high-density lipoprotein cholesterol (CAD: OR, 0.82, 95 percent CI, 0.74–0.91), triglycerides (CAD: OR, 1.29, 95 percent CI, 1.14–1.45), BMI (CAD: OR, 1.25, 95 percent CI, 1.19–1.32), and alcohol dependence (OR, 1.04, 95 percent CI, 1.03–1.06).

These factors, according to the researchers, represent important targets for CVD prevention.