Gene map may identify heart disease risk for people with Typediabetes


Date:
April 4, 2022
Source:
American Heart Association
Summary:
A new study confirmed a risk score, based on a map of genetic
variants known to affect blood pressure, successfully identified
people with Type 2 diabetes who are at increased risk for heart
attack or stroke. Genetic risk scores, like the one examined
in this study, may help identify risk very early in the disease
process and indicate the need for more intensive prevention efforts,
such as healthy lifestyle changes among people with Type 2 diabetes.



FULL STORY ==========================================================================
A risk score based on a gene map predicted the likelihood of high blood pressure leading to heart problems or stroke in people with Type 2
diabetes, according to a study published today in the American Heart Association's peer- reviewed journal Hypertension. This tool may be
especially useful in guiding treatment for people who are newly diagnosed
with Type 2 diabetes or for those with prediabetes.


========================================================================== Previous research has confirmed adults with Type 2 diabetes are twice
as likely to have a heart attack or stroke than people who do not have
Type 2 diabetes.

Various measures of health status, such as blood pressure, cholesterol and blood sugar levels, are commonly used to determine a person's risk for developing heart disease. In this study, researchers explored whether
genetic variants linked with high blood pressure are also linked to
later heart disease or stroke for people with Type 2 diabetes and used
that information to determine a risk score.

"Increased genetic risk of high blood pressure may predispose some
people with Type 2 diabetes to a higher risk of heart attack, stroke
or cardiovascular death," said lead study author Pankaj Arora, M.D.,
director of the Cardiogenomics Clinic Program and the Cardiology Clinical
and Translational Research Program at the University of Alabama at
Birmingham. "We conducted the study to determine if this genetic risk
score can identify people with Type 2 diabetes who have a higher risk
for cardiovascular events and if tight control of blood sugar impacts
the link between genetic hypertension risk and cardiovascular outcomes."
Arora and colleagues assessed the health records of 6,335 participants
in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial database for whom genetic data were available. The study group consisted
of 37% women, and participants self-identified their race or ethnicity:
15% were African American, 6% were Hispanic; 70% were white; and 9%
selected the category "other." All participants had Type 2 diabetes and elevated blood pressure, and they were followed for 3.5 years.

A genetic variant map of more than 1,000 common genetic variants known to affect blood pressure was compared to the DNA of the study participants to determine participants' genetic risk. More matches among the participant's
DNA and the map of known blood pressure genetic variants equated to a
higher genetic risk score.

Researchers found that the genetic risk score identified study
participants with a higher risk of cardiovascular events:
* For people with higher than average genetic risk scores, each degree
higher was associated with a 12% higher risk of heart disease or
stroke events.

* The association of genetic risk with cardiovascular events was
the same
even if participants were taking medicines to manage blood sugar
levels.

Further evaluation of genetic risk scores in people who do not have Type
2 diabetes is needed to be able to apply these findings more broadly.

Arora and colleagues also noted the findings about differences in
individuals' genetic risk scores for high blood pressure did not entirely explain why intensive glycemic control (aggressive treatment with insulin, medications, diet and exercise) did not appear to have a cardiovascular
benefit for people with long-standing Type 2 diabetes.

"However, a genetic risk score maybe helpful for people newly diagnosed
with Type 2 diabetes to identify who should have more intense lifestyle changes, such as changes in diet and exercise, and more aggressive
management of weight, blood pressure and smoking cessation," said Arora.

"If you have Type 2 diabetes, there's a lot you can do to reduce
your risk for heart disease," said Eduardo Sanchez, M.D., M.P.H.,
FAHA, FAAFP, the American Heart Association's chief medical officer
for prevention, who is the clinical lead for Know Diabetes by Heart,
a collaborative initiative between the American Heart Association and
the American Diabetes Association addressing the link between diabetes
and cardiovascular disease. "In addition to blood sugar control, which
is absolutely paramount, we highly encourage people living with Type 2
diabetes to talk with their health care team about other personal and
familial risk factors for heart disease or stroke, and what they can
do to manage or modify them." Co-authors include Vibhu Parcha, M.D.;
Akhil Pampana, M.S.; Adam Bress, Pharm.D., M.S.; Marguerite R. Irvin,
Ph.D.; and Garima Arora, M.D.


========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Vibhu Parcha, Akhil Pampana, Adam P. Bress, Marguerite R. Irvin,
Garima
Arora, Pankaj Arora. Association of Polygenic Risk Score With Blood
Pressure and Adverse Cardiovascular Outcomes in Individuals With
Type II Diabetes: Insights From the ACCORD Trial. Hypertension,
2022; DOI: 10.1161/HYPERTENSIONAHA.122.18976 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220404082855.htm

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