“Genetics is an important contributor to premature heart disease but should not be used as an excuse to say it is inevitable.”
Having heart disease may be due to genetic causes, but unhealthy lifestyle, for example physical inactivity, smoking, high blood pressure, diabetes, and high cholesterol, plays a greater role than genetics in many young patients with heart disease.

This is a new study presented at ESC Congress 2019 together with the World Congress of Cardiology. Study shows that healthy behaviors are a top priority for reducing heart disease, even in those with a family history of early onset.
According to the study author, young patients diagnosed with premature heart disease were frequently smokers, physically inactive, with high cholesterol levels and high blood pressure, although they sought shelter and explanations in their genetics or family history.

The study recruited 1.075 patients under 50, with an average age of 45 and 87% males as the treatment group. 555 of the participants had coronary artery disease (known as premature CAD) with specific conditions including stable angina, heart attack, and unstable angina.
As for the control group, there were 520 healthy volunteers, with an average age of 44 ad 86% males.

5 modifiable risk factors were assessed:
Physical inactivity
Smoking
High blood pressure
Diabetes
High cholesterol
Nearly three quarters (73%) of patients had at least three of these risk factors, compared to 31% of controls.
In both groups, the likelihood of developing CAD increased exponentially with each additional risk factor. If we consider the possibility of a healthy person with no risk factor having CAD as 1, the following form can give you a better understanding:
The number of risk factor(s) people have | 0 | 1 | 2 | 3 |
Likelihood of having CAD | 1 | 3 | 7 | 24 |
Besides, all participants also underwent genome sequencing aiming at developing a genetic risk score containing 33 variants thought to contribute to CAD or risk factors such as high blood pressure.
The average score was high in the treatment group (patients) than the control group (non-patients). Although the score was an independent predictor for premature CAD, the influence became less obvious with the number of modifiable risk factors rose.
"The findings demonstrate that genetics contribute to CAD. However, in patients with two or more modifiable cardiovascular risk factors, genetics play a less decisive role in the development of CAD." Said the study author.

Don’t be so worry if you have genetic or family history of developing CAD. Better lifestyle can certainly reduce your risk of having heart disease. On the contrary, two or more risk factors can increase your risk of CAD by tens of times even if your family history is totally clear.
Quit smoking, exercise regularly, eat a healthy diet, and get blood pressure and cholesterol levels checked. You are safer than you think in terms of developing CAD.