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Hundreds of thousands of adults in the UK could benefit from taking statins as their genes expose them to a high risk of heart disease, according to research.
Speaking Wednesday at the British Biobank conference in London, Professor Sir Peter Donnelly, founder of Genomics Plc, warned of an "invisible population" that is not identified as being at risk by current screening programs because their blood pressure and cholesterol are not. raise red flags.
"There are many people who are not on the radar, who would not have been offered statins, but who are at high risk by including genetics," he said.
Donnelly, who was previously director of the Wellcome Center for Human Genetics, is launching a new type of predictive DNA test, which measures the contributions of thousands of genes. Earlier this year, Health Secretary Matt Hancock called for this type of testing, to assess the risk of common cancers and heart disease, to be rolled out immediately on the NHS.
The latest work suggests that risk genes for heart disease can work independently of known risk factors, including hypertension and cholesterol, which are used by general practitioners to decide whether a person would benefit from drugs such as statins.
This means that if a DNA test were included in national screening, as proposed by Hancock, people in the "high risk" category would be significantly overhauled, representing a 10% risk of heart disease over the next 10 years.
Donnelly's research suggests that if one million adults aged 40 to 55 years old are at high risk for heart disease, if a genetic risk score was also included, about a quarter of these people could be transferred to the low-risk category . Indeed, even though their cholesterol levels and blood pressure may be above average, they carry protective genes that significantly reduce the risk of heart attack or stroke.
However, the genetic test would also displace 528,000 adults who would have been previously forgotten in the high-risk category because of their genetic profiles. Currently, about 4 million people are treated with statins in England.
"You end up with more people above the risk threshold, but they are not the same people," Donnelly said. "Many of these high-risk people are currently invisible to the health system.
"We are now focusing on how to integrate the genetic scores for heart disease in the NHS equitably, and that help, rather than further complicate, already overburdened family doctor practices."
Further work is needed to determine whether this hidden population would benefit from cholesterol-lowering statins to the same degree as those with high cholesterol levels. However, a previous study indicates that preventive medications are those with the most risky genetic profiles.
Tim Chico, a professor of cardiovascular medicine at the University of Sheffield, said that genetic scores would most likely play a role in managing heart health over the next decade. Although statins play a crucial role, Chico said, doctors should also focus on the social and environmental factors contributing to heart disease, including diet and exercise.
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