Healthy lifestyle helps prevent CHD despite genetic susceptibility to obesity

People with high or medium genetic risk of abdominal obesity but who have a healthy lifestyle are less likely to develop coronary heart disease (CHD) than those with low genetic risk and an unhealthy lifestyle, a study has shown.

A total of 282,316 White British individuals from the UK Biobank were assessed in this study. The authors estimated the genetic risk for high waist-to-hip ratio (WHR) via weight polygenic risk scores (PRS), calculated based on 156 single-nucleotide polymorphisms.

Lifestyle scores were calculated based on five healthy factors: regular physical activity, no current smoking, a healthy diet, <3 times/week of alcohol consumption, and 7‒9 hours per day of sleep.

Overall, 11,635 incident CHD occurred over a median follow-up of 13.8 years. Twelve individual cardiovascular disease (CVD) risk markers were assessed at baseline.

Adherence to a healthy lifestyle (4‒5 healthy factors) resulted in a 25-percent (hazard ratio, 0.75, 95 percent confidence interval [CI], 0.70‒0.81) lower risk of CHD compared with an unfavourable lifestyle (0‒1 factor), independent of PRS for high WHR.

Participants with favourable lifestyle at high or medium genetic risk had a lower estimated 12-year absolute risk of CHD than those with an unfavourable lifestyle at low genetic risk (1.73 percent and 1.67 percent vs 2.08 percent).

Following a healthy lifestyle contributed to healthier levels of CVD risk markers (except random glucose and high-density lipoprotein), independent of PRS for high WHR.

“Future clinical trials of lifestyle modification could be implemented for individuals at high genetic risk of abdominal obesity for the primary prevention of CHD events,” the authors said.