Cardiovascular disease: The heart of the family

Doctors have long known that heart disease runs in the family. Researchers are now trying to pinpoint the genetic links to target prevention and tailor treatment.

By Victoria Stagg Elliott, AMNews staff. Oct. 1, 2001.

Mapping Disease
As the results of the Human Genome Project began to shake out into clinical applications, this 2001-02 series detailed progress in the prevention and treatment of a variety of diseases and conditions -- both on the near horizon and possibilities far into the future.

The family history, an elementary form of genetics, has long been a tool used in targeting heart disease prevention strategies to those who need them most.

Patients deemed at risk are told to exercise more, eat less fat, lose weight, quit smoking. If that doesn't work, they are given prescriptions to lower cholesterol and blood pressure. Some of these strategies are appropriate for most patients, but especially important for those whose close relatives have dodgy tickers.

But, despite all these efforts and the recent revolutionary impact of statins, heart disease remains the No. 1 killer in the United States. One in four Americans live with some form of it. And researchers have long tried to approach the set of related conditions from a genetics perspective, finding genes implicated in the Mendelian disorders that cause congenital heart defects. The genes implicated in the more common forms of heart disease, however, remained elusive. There were just too many of them.

"Nature has dealt us a pretty complicated hand in terms of how genes work and network and interact," said Ronald M. Krauss, MD, senior scientist with the University of California's Lawrence Berkeley National Laboratory. "Our task is to somehow get on top of that."

There are the genes for obesity, high blood pressure and diabetes -- all of which make people more susceptible to heart disease.

"But not everybody that's obese gets heart disease," said Dr. Krauss. "If you could eliminate obesity, you would eliminate a lot of heart disease, but you really want to go for the underlying target." [...]