Utility of genetic determinants of lipids and cardiovascular events in assessing risk

Nat Rev Cardiol. 2011 Apr;8(4):207-21. doi: 10.1038/nrcardio.2011.6. Epub 2011 Feb 15.


The prevention of coronary heart disease (CHD) is a major public-health goal, but disease architecture is such that a larger proportion of clinical events occur among the average majority than among the high-risk minority--the prevention paradox. Genetic findings over the past few years have resulted in the reopening of the old debate on whether an individualized or a population-based approach to prevention is preferable. Genetic testing is an attractive tool for CHD risk prediction because it is a low-cost, high-fidelity technology with multiplex capability. Moreover, by contrast with nongenetic markers, genotype is invariant and determined from conception, which eliminates biological variability and makes prediction from early life possible. Mindful of the prevention paradox, this Review examines the potential applications and challenges of using genetic information for predicting CHD, focusing on lipid risk factors and drawing on experience in the evaluation of nongenetic risk factors as screening tests for CHD. Many of the issues we discuss hold true for any late-onset common disease with modifiable risk factors and proven preventative strategies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / genetics
  • Coronary Artery Disease / prevention & control*
  • Ethnic Groups
  • Genetic Testing
  • Genetic Variation
  • Genome, Human
  • Genome-Wide Association Study
  • Humans
  • Lipids / blood*
  • Risk Assessment / methods*
  • Risk Factors


  • Lipids