Background Multiple genetic loci are associated with clinical cardiovascular (CV) disease and individual CV risk factors. Individuals with ideal levels of all major CV risk factors have very low risk for CV disease morbidity or mortality. Ideal levels of risk factors can be attained by lifestyle modifications; however, little is known about gene variants associated with ideal CV health. Our objective was to carry out a genome-wide association study on the trait. Methods and Results We examined 2 dichotomous phenotypes of ideal CV health - clinical (untreated cholesterol <200 mg/dL, untreated blood pressure <120/<80, not diabetic) and clinical + behavioral (clinical plus: not a current smoker, body mass index <25 kg/m2) - among white participants aged 50 ± 5 years. We performed a meta-analysis of 4 genome-wide association studies (total n = 11,708) from the MESA, CARDIA, ARIC, and Framingham Heart Study cohorts. We identified a single-nucleotide polymorphism (rs445925) in the APOC1/APOE region that was associated with clinical ideal CV health at genome-wide level of significance (P < 2.0 × 10-9). The significance of this region was validated using exome chip genotyping. The association with ideal CV health was attenuated after adjusting for low-density lipoprotein cholesterol. Conclusion A common single-nucleotide polymorphism in the APOC1/APOE region, previously found to be associated with protective levels of cholesterol and lower CV risk, may be associated with ideal health. In future replication studies, larger sample sizes may be needed to detect loci with more modest effects on ideal CV health. In addition to the important impact of lifestyle modifications, we have identified evidence for gene variation that plays a role in ideal CV health.
Bibliographical noteFunding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute Contracts ( HHSN268201100005C , HHSN268201100006C , HHSN268201100007C , HHSN268201100008C , HHSN268201100009C , HHSN268201100010C , HHSN268201100011C , and HHSN268201100012C ), R01HL087641, R01HL59367, and R01HL086694; National Human Genome Research Institute Contract U01HG004402 ; and National Institutes of Health Contract HHSN268200625226C . The authors thank the staff and participants of the ARIC study for their important contributions. Infrastructure was partly supported by Grant No. UL1RR025005 , a component of the National Institutes of Health and NIH Roadmap for Medical Research .
This work was supported by the National Heart, Lung and Blood Institute's Framingham Heart Study (Contract No. N01-HC-25195 ).
We acknowledge the important role of the Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortium and the collaboration of the CHARGE Subclinical Atherosclerosis/Coronary Heart Disease Working Group in the development and support of this manuscript.
© 2015 Mosby, Inc. All rights reserved.