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Men can inherit heart disease

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Men can inherit heart disease from their father say scientists who have tracked the condition to the Y chromosome that dads pass to sons.

By studying the DNA of over 3,000 men they found a particular version of the sex chromosome increases the risk of coronary artery disease by 50%.

As many as one in five British men carry this version of Y.

And the risk it confers is in addition to other heart risk factors like cholesterol, The Lancet reports.

Experts already know that men develop heart disease a decade earlier than women, on average. By the age of 40, the lifetime risk of heart disease is one in two for men and one in three for women.

Lifestyle factors like smoking and blood pressure are important contributors. This latest work suggests the male Y chromosome can also play a role in coronary artery disease – a common form of heart disease that kills thousands each year in the UK.

Dr Maciej Tomaszewski, from the University of Leicester, and colleagues studied 3,233 biologically unrelated British men who were already enrolled in other medical studies investigating heart disease risk.

When they carried out genetic tests on the men they found that 90% possessed one of two common versions of Y chromosome – named haplogroup I and haplogroup R1b1b2.

And the risk of coronary artery disease among the men carrying the haplogroup I version was 50% higher than in other men.

The human heart

The human heart

The scientists say they now need to pinpoint precisely which genes on the Y chromosome are responsible.

But they believe they already know how they exert their effect – by upsetting a man’s immune system.

Dr Maciej Tomaszewski, a clinical senior lecturer at the University’s Department of Cardiovascular Sciences, said: “We are very excited about these findings as they put the Y chromosome on the map of genetic susceptibility to coronary artery disease.


“Doctors usually associated the Y chromosome with maleness and fertility but this shows it is also implicated in heart disease.”

He said, ultimately, the discovery could lead to new ways to treat and prevent heart disease in men, as well as a genetic test to spot those greatest risk.

In the meantime, he said men should focus on risk factors that they already have the power to modify themselves, such as getting enough exercise and eating a healthy diet to keep their blood pressure and cholesterol down.

Dr Hélène Wilson of the British Heart Foundation, which part-funded the work, said: “Coronary heart disease is the cause of heart attacks, which claim the lives of around 50,000 UK men every year.

“Lifestyle choices such as poor diet and smoking are major causes, but inherited factors carried in DNA are also part of the picture. The next step is to identify specifically which genes are responsible and how they might increase heart attack risk.”

Heart attack rates in the UK falling

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It is one of medicine’s mysteries: what has caused Britain’s plummeting rate of heart disease over the last decade? Deaths from heart attacks have halved since 2002 and no one is quite sure why. Similar changes have occurred in countries around the world but the death rate in England, especially, has fallen further and faster than almost anywhere.

Researchers from the University of Oxford suggest part of the reason is that our hearts are getting stronger. We are suffering fewer heart attacks than we did and fewer of them are fatal. The two factors may be linked. By reducing risk factors for heart disease – avoiding smoking, eating a healthy diet, cutting cholesterol and lowering blood pressure – we not only reduce heart attacks but ensure that when they occur they are less life threatening.

The researchers looked at 840,000 men and women in England who had suffered a total of 861,000 heart attacks between 2002 and 2010. Overall, the death rates fell by 50 per cent in men and 53 per cent in women. The reasons for the decline, they say, are “beneficial changes in the health of the population” and “major improvements in NHS care” for those who end up in hospital. But the findings were not uniform across the country. In London heart attack rates rose between 2007 and 2009 – probably as a result of the financial crisis.

Many puzzles remain. “The causes of the increase and decline in heart disease deaths are not entirely straightforward,” said Professor Michael Goldacre, of the Department of Public Health, who led the study published in the British Medical Journal.

For the last 70 years we have been in the grip of a heart disease epidemic that began in the 1940s, rose to a peak in the 1970s and then began to fall. All Western countries were affected and all followed broadly the same pattern.

The human heart

The human heart

At first it was thought to be a nutritional disorder linked to fat in the diet. The American epidemiologist Ancel Keys argued that if fat consumption could be reduced, cholesterol levels would fall and the narrow coronary arteries that supply the heart would be protected from atheroma, the thickening with fatty deposits that causes blockages.

His theory has held sway for 50 years and the central role of cholesterol in heart disease is accepted round the world. But the role of fat is less clear. Total fat consumption in the UK has changed little – down from 40 per cent of average calories in the 1980s to 38 per cent today (though there has been a bigger reduction in the most harmful type, saturated fat).


In 2000, a pan-European study by the World Health Organisation was unable to show a convincing link between heart disease levels and fat consumption in the 21 countries studied.

Smoking, meanwhile, makes blood more likely to clot and is a known cause of heart attacks. But smoking peaked in the 1940s and then began to decline, just as the heart disease epidemic was taking off. Unlike cancer, which can take decades to develop, smoking’s impact on the heart is immediate.

Heart disease has largely affected men. Yet from the 1940s onwards, smoking, fat consumption and blood pressure increased equally in women. In 2001, researchers in Bristol showed that women who consumed the most fat had the lowest rate of heart disease.

The conventional explanation is that women are protected by the female hormone oestrogen. But biological differences between the sexes are “not well understood,” Professor Goldacre said.

International differences also remain unexplained. Epidemiologists have puzzled for decades why the French, despite their love of meat, cheese and cream, suffer fewer heart attacks than we do. Red wine, with its anti-oxidant properties, is usually cited as France’s secret weapon. In the south, closer to the Mediterranean, olive oil and salad are also cited. American researchers have suggested a simpler explanation – that the French escape heart disease because they eat less of everything. Obesity rates in France, though rising, are lower than in the UK.

The Oxford researchers conclude that just under half the decline in heart attack death rates in England over the last decade is due to better hospital treatment; the rest is due to changes in lifestyle and the widespread use of pills to lower cholesterol and blood pressure.