Do You Have the Heart Attack Gene?

More than 50% of Americans carry one or more gene variants that dramatically raise their risk for heart attacks and strokes. The good news, however, is that even people with high-risk genes can avoid cardiovascular (CV) events by following the right personalized prevention plan. Not only can genetic testing reveal CV threats that may be lurking in your DNA, but it can also reveal the best strategies to treat them.

Here’s a look at 3 newly available blood or saliva genetic tests I recommend to all of my patients and the results can help optimize CV health, as the experiences of my patient, Wayne Williams, highlight.

• 9P21 Genotype: Identifies Carriers of the Heart Attack Gene. This test checks for the 9P21 gene, often called “the heart attack gene,” because it independently predicts risk even when family history, diabetes, high blood pressure and obesity are taken into account. About 25% of Caucasians and Asians are homozygous for 9P21, meaning they’ve inherited the gene from both their mother and father. This genetic profile more than doubles risk for having a heart attack or developing heart disease at a young age, and hikes risk for abdominal aortic aneurysm (AAA) 74%, compared to non-carriers of this gene. Fifty percent of Caucasians and Asians are heterozygous for 9P21. With only have one copy of the gene, their risk for these disorders is halved.

  How the results can be used to protect arterial health: If you’re a 9P21 carrier, reduce your heart attack risk with the genetically guided 7-step prevention plan in Chapter 10 of my book, Beat the Heart Attack Gene. We also advise carriers to be screened for AAA at age 40, with an ultrasound test discussed in the book. If the results are normal, the test should be repeated every five years, while abnormal results require more frequent follow-up.

• KIF6 Genotype: Predicts Statin Response and Heart Attack Risk. This test checks for a KIF6 gene variant that raises risk for heart attack, stroke and death from CV causes by up to 55% in untreated carriers, compared to untreated non-carriers. Your KIF6 genotype also predicts whether or not you’ll benefit from the statins most likely to be prescribed for heart attack prevention.

  How the results can be used to protect arterial health: If you’re on Lipitor–the world’s most commonly prescribed statin–or Pravachol as your sole therapy, there is a 40% chance you are getting no CV protection at all, even if your cholesterol levels look great. Three large studies show that these drugs only reduce risk in the 60% of patients with the KIF6 variant, such as Wayne, while failing to prevent CV events in the 40% of patients without it. It’s vital for medical providers to know your KIF6 status to make sure the statin they prescribe will effectively lower heart attack risk.

• Apo E Genotype: Predicts Heart Disease and the Best Diet to Avoid It. Apo E genotype influences lifetime risk for heart disease and Alzheimer’s, as well as how your body metabolizes nutrients in your diet, including fats and carbs. The Apo E gene has three variants (E2, E3 and E4), resulting in six possible genotypes, Apo E 2/2, Apo E 2/3, Apo E 2/4, Apo E 3/3, Apo E 3/4 and Apo E 4/4.

  How the results can be used to protect arterial health: Some Apo E genotypes make foods that are healthy for people with other Apo E genotypes harmful. For example, the 25% of the population with the Apo E 3/4 or 4/4 genotypes, which are linked to the highest heart disease and Alzheimer’s risk, should follow a very low-fat diet (no more than 20% fat) and limit or avoid alcohol, while those with the 2/4 or 3/3 genotypes (found in 60% of people) benefit most from the Mediterranean diet that is often advised for lowering heart attack and stroke risk. Wayne’s diet should contain about 25% fat. To learn more about the best diet-and-exercise plan for your DNA, read chapter 12 of Beat the Heart Attack Gene, now available in paperback and Kindle editions on Amazon.