Genetic Risk, Adherence to a Healthy Lifestyle, and Ischemic Heart Disease

  • Thomas F. WhayneJrEmail author
  • Sibu P. Saha
Ischemic Heart Disease (D Mukherjee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Ischemic Heart Disease


Purpose of Review

The purpose of this review is to investigate and discuss two aspects of coronary artery disease (CAD)—genetic risk and therapeutic lifestyle change (TLC)—both of which have key importance for patients and their care but which actually receive inadequate attention.

Recent Findings

Genetic risk has generally been relegated to a broad association with the presence of one or more inherited cardiovascular (CV) risk factors such as hypercholesterolemia, family history of atherosclerosis, hypertension, and diabetes mellitus. However, the future of genetic risk is an understanding of specific genes, a genetic risk score, specific genetic loci known as selective nucleotide polymorphisms (SNPs), specific alleles, and microribonucleic acids (miRNAs). Healthy lifestyle is fashionably referred to as TLC and encompasses physical fitness, exercise, behavioral modification, diet, and stress reduction.


In the past decade, aggressive treatment of cholesterol with statins has received the major emphasis for CV risk reduction. Genetics, of course, can only be modified by factors that influence epigenetics, and TLC could have an effect on genetics by this mechanism. On the other hand, each individual component of TLC has been shown to contribute to a reduction of CV risk. Although aggressive pharmaceutical approaches are now in vogue, whatever TLC can contribute, depending on the degree of individual patient adherence, should never be forgotten.


Atherosclerosis Coronary artery disease Genetics Hyperlipoproteinemias Lipoprotein (a) Low-density lipoprotein cholesterol Therapeutic lifestyle change 



Atrial fibrillation


Coronary artery disease


Carotid intima-media thickness


Colony-stimulating factor 1


Computed tomography angiography




Cell-derived factor 1


Diabetes mellitus


Genetic risk score


Health Heart Score


High sensitivity C-reactive protein


Low-density lipoprotein


Low-density lipoprotein cholesterol


Lipoprotein (a)


Mediterranean diet


Metabolic syndrome


Myocardial infarction


Microribonucleic acids




Peripheral arterial disease


Percutaneous coronary intervention


Proprotein convertase subtilisin/kexin type 9


Sudden cardiac death


Selective nucleotide polymorphisms


Therapeutic lifestyle change


United Kingdom



The authors thank Colleen McMullen, MA, MBA, for her excellent editorial critique.

Compliance with Ethical Standards

Conflict of Interest

Thomas F. Whayne, Jr. and Sibu P. Saha confirm that there are no conflicts of interest involving any pharmaceutical or medical device company or any other possible conflict.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Gill Heart and Vascular InstituteUniversity of KentuckyLexingtonUSA
  2. 2.Gill Heart and Vascular InstituteLexingtonUSA

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