CORONARY HEART-DISEASE AND GENETICS - AN EPIDEMIOLOGISTS VIEW

We are just beginning to uncover the genetic determinants of coronary heart disease. The genotype phenotype associations are complex as a co nsequence of pleiotropy, variation with age, selection owing to the hi gh lethality of the disease, and interaction between genes and with en vironmental factors. Nevertheless, identification of the gene variants involved in the chronic and acute processes of coronary heart disease appears possible; this could considerably improve our understanding o f the aetiology and mechanisms of this disease. Simultaneous analysis of several predisposing alleles should provide the means to identify h igh-risk individuals and to adapt therapeutic approaches to the geneti c make-up of patients.