Study of the interplay of genetic, biochemical, and lifestyle factors on coronary heart disease incidence

心脏病是英国和全球的头号杀手，导致相当大的残疾，并涉及几个重要的可改变的风险因素，如吸烟、糖尿病以及胆固醇和血压水平升高。心脏病发作的发生取决于基因构成、环境因素和偶然性的复杂相互作用。了解大自然的相互作用？然后呢？培养？心脏病方面的研究应有助于在以下方面取得重要进展：(1)解释导致心脏病发作的生物链；(2)有效针对预防疾病的现有措施；(3)为人们制定生活方式方案，以抵消不利的基因特征。直到最近，还很难研究基因、生化因素和生活方式(如饮食习惯和体力活动)在冠心病中的相互作用。医学调查往往太小，不够详细，设计不当，或具有这些限制的某种组合。此外，只是在过去的几年里，基因研究才确定了相当多的与心脏病和相关特征(如血脂水平、肥胖和糖尿病)有关的遗传因素。目前的研究项目试图通过对生活在10个国家的50多万名中年欧洲人的现有调查，对心脏病的遗传、生化和生活方式因素进行大规模而详细的研究。从20世纪90年代初开始，最初健康的参与者献血，回答调查问卷(例如，关于生活方式、习惯)，并提供体格测量。这些人现在平均被监测了十多年，在此期间有1万多人心脏病发作。建议对10,000名确诊心脏病患者和10,000名未患心脏病的对照组的储存样本进行基因和生化测试。然后，这些人的遗传和生化信息将与首次就诊时记录的吸烟习惯、饮食、体力活动和其他特征信息进行核对，以创建一个丰富而强大的数据库。这一数据库将被仔细收集，以产生一系列对了解、预测和预防心脏病具有重大国际意义的即时和长期发现。

Heart disease is the single leading killer in the UK and globally, is responsible for considerable disability, and involves several important modifiable risk factors, such as smoking, diabetes, and elevated levels of cholesterol and blood pressure. The occurrence of heart attacks depends on the complex interplay of genetic make-up, environmental factors and chance. Understanding the interplay of ?nature? and ?nurture? in heart disease should contribute to important advances in: (i) explaining the biological chain of events that leads to a heart attack, (ii) effectively targeting existing measures to prevent disease, and (iii) developing lifestyle programmes for people to counteract disadvantageous genetic profiles. Until recently, it has been difficult to study the interplay of genes, biochemical factors and lifestyles (eg, dietary habits and physical activity) in CHD. Medical surveys have tended to be too small, insufficiently detailed, inappropriately designed, or had some combination of these limitations. Also, it is only in the past few years that genetic research has identified a reasonably large number of genetic factors related to heart disease and relevant characteristics (such as levels of blood fats, obesity and diabetes). The current research project seeks to conduct a large and detailed study of genetic, biochemical and lifestyle factors in heart disease by using an existing survey of over 500,000 middle-aged Europeans living in ten countries. Starting in the early 1990s, initially healthy participants gave blood, replied to questionnaires (eg, about lifestyles, habits) and provided physical measurements. These individuals have now been monitored for over a decade on average, during which time more than 10,000 people have had heart attacks. It is proposed to conduct genetic and biochemical tests in the stored samples of 10,000 patients with confirmed heart disease and in 10,000 controls who have remained free of heart disease. Genetic and biochemical information assessed in these individuals will then be collated with information on smoking habits, diet, physical activity and other characteristics previously recorded at the initial visit to create a rich and powerful database. This database will be carefully harvested to yield a series of immediate and longer-term findings of major international importance for the understanding, prediction and prevention of heart disease.