According to the British Society for Human Genetics (BSHG) conference you'd adopt a healthier lifestyle if you discovered your family history placed you at very high risk of coronary heart disease (CHD), right? Not if you're facing debt or high housing costs, according to a new study.
A team led by Dr Paula Saukko from Loughborough University has discovered that genetic and family history alone isn't enough to motivate people at high risk of CHD. To change their lives, they also need to have a supportive family and doctor, and to be personally and financially secure. The work could have implications for how doctors tackle CHD and other public health issues.
'Whether it's family or a very difficult financial situation, genetic information needs to be placed in context', she says. The team was working as part of a Department of Health funded study of 700 people in the East Midlands and South West of England. They interviewed 30 people at high risk of CHD 2 weeks and 6 months after those people had talked to a GP about their heart disease risk, lifestyle and medication.
The people who took no action to reduce their CHD risk were facing very difficult circumstances. 'They had high cost of housing, financial problems, depression and other illnesses. Other stuff was higher priority for them', she says. 'They said things like "If I can't pay the mortgage, I can't concentrate on this".
Healthiness is a Family Thing
People who took tablets to reduce cholesterol and changed their lifestyle, however, had a supportive family and clinicians. 'People change their lifestyle as a family, because families shop, prepare food and eat together', says Dr Saukko. 'If the men had high risk, they went walking with their wife as a couple. Some couples were both at high risk and they acted together'.
Pill Popping alone is not Enough
The study also found that people whose doctor focused on reducing CHD risk by bringing down cholesterol levels tended only to take cholesterol-reducing tablets. They didn't make efforts to get healthy. 'They saw the problem had been resolved. They said things like "I take the tablets and my cholesterol goes down"', Dr Saukko says. 'GPs need to pay a bit more attention to whether they offer the drugs too readily. Sometimes doctors and nurses focus on the genetics to encourage people to take the tablets'.
People who didn't take tablets, but made lifestyle changes, often felt tablets were 'unnatural'. They said they felt eating right and taking more exercise made them feel healthier and improved their wellbeing.
Anyone concerned about chest pain should see the latest lipid and cardiology risk assessment methods.
