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Smoking modifies the associated increased risk of future cardiovascular disease by genetic variation on chromosome 9p21.

ABSTRACT: AIMS: Genetic predisposition for cardiovascular disease (CVD) is likely to be modified by environmental exposures. We tested if the associated risk of CVD and CVD-mortality by the single nucleotide polymorphism rs4977574 on chromosome 9p21 is modified by life-style factors. METHODS AND RESULTS: A total of 24,944 middle-aged subjects (62% females) from the population-based Malmö-Diet-and-Cancer-Cohort were genotyped. Smoking, education and physical activity-levels were recorded. Subjects were followed for 15 years for incidence of coronary artery disease (CAD; N?=?2309), ischemic stroke (N?=?1253) and CVD-mortality (N?=?1156). Multiplicative interactions between rs4977574 and life-style factors on endpoints were tested in Cox-regression-models. We observed an interaction between rs4977574 and smoking on incident CAD (P?=?0.035) and CVD-mortality (P?=?0.012). The hazard ratios (HR) per risk allele of rs4977574 were highest in never smokers (N?=?9642) for CAD (HR?=?1.26; 95% CI 1.13-1.40; P<0.001) and for CVD-mortality (HR?=?1.40; 95% CI 1.20-1.63; P<0.001), whereas the risk increase by rs4977574 was attenuated in current smokers (N?=?7000) for both CAD (HR?=?1.05; 95%CI 0.95-1.16; P?=?0.326) and CVD-mortality (HR?=?1.08; 95%CI 0.94-1.23; P?=?0.270). A meta-analysis supported the finding that the associated increased risk of CAD by the risk-allele was attenuated in smokers. Neither education nor physical activity-levels modified the associated risk of CAD, ischemic stroke and CVD mortality conferred by rs4977574. CONCLUSION: Smoking may modify the associated risk of CAD and CVD-mortality conferred by genetic variation on chromosome 9p21. Whether the observed attenuation of the genetic risk reflects a pathophysiological mechanism or is a result of smoking being such a strong risk-factor that it may eliminate the associated genetic effect, requires further investigation.

SUBMITTER: Hamrefors V 

PROVIDER: S-EPMC3899088 | BioStudies | 2014-01-01

REPOSITORIES: biostudies

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