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Show Heart Attacks Claim Third of All Deaths One third of all deaths In America are caused by Wat attacks, according to f)r. Roger Williams, Associate professor of jcardiology at the 3L'niversity of Utah Medical Center. Many heart attacks could be postponed or prevented if individuals with a high risk of heart disease were identified earlier, according to Dr. Williams He and several colleagues are pioneering an attempt to identify such people through the use of genealogical records "There is a unique opportunity in Utah to fstudy the genetic aspect i'of heart disease through jthe Church of Jesus Ichrist of Latter-day Jsaints genealogical library and through the people's own knowledge," says Dr. Williams. "The stability of the population in Utah is a factor too. We want to not only find out about a person's relatives but also examine them. Here, you find many or all of the people In a given pedigree living relatively close together." "Less than 10 percent of all heart attacks occur in people under the age of 55," says Dr. Williams "We want to find out what role genetics play in the occurrence of premature heart attacks. If it's an important influence, as I think we will find it is, there could be profound public health implications. Then perhaps more money would be made available to prevent heart disease." Dr. Williams and his colleagues are trying to determine what percentage of early heart attacks are caused by genetic predisposition, which inherited factor may cause heart disease in each case and how heart attacks could be delayed or prevented. The first part of the study began a year ago To collect population data, the group is linking a file of 135,000 death certificates, including 40,000 heart attack deaths, with computerized genealogical information. The National Institutes of Health support this three-year part of the project at $90,000 a year. "From this study," Dr. Williams says, "we'll be able to identify the major high-risk families in Utah. We hope to be able to examine a random sample of these families." In April, a high-risk coronary clinic was opened to examine families referred by their physicians. "The screening clinic is still a pilot project." explains Dr. Williams. "The clinic is open one afternoon a week and we can only take one family at a time. We hope to gain enough information from this to support another grant application in a year or two." The cardiologist hopes to continue the project for 20 years, fallowing up on each family to determine the results of recommended heart disease prevention methods. Dr. Williams, cardiologist Dr. Frank Yanowitz, lipid specialists Dr. Dana Wilson and Dr Corwin Edwards, geneticists Dr. Mark Skolnick and Dr Dorit Carmelli, and behavioral psychologist Dr Richard Stuart donate their time to the project. Other University of Utah personnel include lab technicians and computer programmers. Gayle Reiber, RN, MPH, of the Utah State Health Division's Bureau of Chronic Disease Control, supervises coronary clinic per sonnel The clinic is held in the University of Utah Medical Center's clinical research center. In the clinic, a potentially high risk coronary patient I usually a brother or son of someone who has had a premature heart attack) is examined along with his wife and children. The family's history is studied as far back as possible. Blood fat levels, blood pressure and subcatenous (at thickness are measured for each family member. Genetic factors and envrionmental factors such as diet, stress, income, smoking habits and occupation are considered. "We look for abnormalities that fall into a genetic pattern," says Dr. Williams, "in hopes of gaining insight into what might be the genetic mechanism causing the heart disease." The final part of the project is determining and testing ways to delay heart disease. Well-known intervention methods, according to Dr. Williams, include diet modification, weight reduction, elimination of smoking, tighter control of diabetes, and exercise and drugs for blood pressure control. He says other intervention methods need to be found which will be tailored to other genetic factors leading to heart attacks. "Prevention needs to begin in childhood." Dr. Williams emphasizes. "One special advantage to our approach is that intervention is not an individual matter but a family matter. For instance, a housewife is more likely to change the way she cooks if it's for her children than just for herself. If we can at least delay a heart attack so that it happens at age 65 instead of 55, that person gains 10 years of productive life." |
