Genetics of coronary heart disease

Abstract

Coronary heart disease (CHD) is the single commonest cause of death in the developed world. One in four men and one in six women die from CHD. In the UK, around 15% of these deaths occur under the age of 65, and 35% under the age of 75 (www.heartstats.org). CHD frequency varies between populations, with the highest age-adjusted rates of 600-1000 deaths per 100 000 found in countries of the former Soviet Union and the lowest at around 60 per 100 000 in Japan (World Health Organization 2002, www.who.ch/). Age-adjusted rates in the UK and USA are around 200-300 per 100 000 of population. Age-adjusted CHD prevalence in the UK and USA has fallen by around 40% in the past 30 years, although this reflects more a postponement in age of CHD-related death by about 10 years rather than an absolute reduction in numbers of deaths (Fuster, 1999). CHD is predicted to remain the commonest single cause of death in developed countries over the next 20 years and will increase in frequency to become the commonest cause of disease-related disability in both developed and developing countries by the year 2020 (Murray and Lopez, 1997). Genetic and environmental contributions to CHD pathogenesis The significant changes in CHD incidence and mortality over the past 20 years can be attributed at least in part to variation in known environmental risk factors (Table 24.1). � Cambridge University Press 2007 and Cambridge University Press, 2009.