Joint association between education and polygenic risk score for incident coronary heart disease events: a longitudinal population-based study of 26 203 men and women

Pekka Martikainen*, George Davey Smith, et al.

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

ABSTRACT
Background: Genetic vulnerability to coronary heart disease (CHD) is well established, but little is known whether these effects are mediated or modified by equally well-established social determinants of CHD. We estimate the joint associations of the polygenetic risk score (PRS) for CHD and education on CHD events.
Methods: The data are from the 1992, 1997, 2002, 2007 and 2012 surveys of the population-based FINRISK study including measures of social, behavioural and metabolic factors, and genome wide genotypes (N=26 203). Follow-up of fatal and non-fatal incident CHD events (N=2063) was based on nationwide registers.
Results: Allowing for age, sex, study year, region of residence, study batch and principal components, those in the highest quartile of PRS for CHD had strongly increased risk of CHD events compared to the lowest quartile (HR=2.26; 95% confidence interval: 1.97, 2.59); associations were also observed for low education (HR=1.58; 95% confidence interval: 1.32, 1.89). These effects were largely independent of each other. Adjustment for baseline smoking, alcohol use, body mass index, HDL and total cholesterol, blood pressure and diabetes attenuated the PRS associations by 10% and the education associations by 50%. We do not find strong evidence of interactions between PRS and education.
Conclusions: PRS and education predict CHD events, and these associations are independent of each other. Both can improve CHD prediction beyond behavioural risks. The results imply that observational studies that do not have information on genetic risk factors for CHD do not provide confounded estimates for the association between education and CHD.
Original languageEnglish
Pages (from-to)651-657
Number of pages7
JournalJournal of Epidemiology and Community Health
Volume75
Issue number7
Early online date6 Jan 2021
DOIs
Publication statusPublished - 1 Jul 2021

Bibliographical note

Funding Information:
Funding This work was supported by grants 308247 and 294861 from the Academy of Finland, Horizon 2020 innovation action award number 667661 from the European Commission (project MINDMAP) and the Finnish Foundation for Cardiovascular Research.

Funding Information:
Competing interests VS reports personal fees and non-financial support from Novo Nordisk, personal fees from Sanofi and grants from Bayer, outside the scope of the submitted work. All the other authors have nothing further to declare.

Publisher Copyright:
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Keywords

  • Education
  • Polygenic risk
  • interaction
  • Coronary heart disease

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