I was at the Heart Institute yesterday to hear about the genetics of heart disease.  This is an important subject, because population studies have shown that about half of all heart attacks and strokes are due to inherited factors.  The speaker was Dr Rob Roberts, who is the Canadian lead investigator of the CARDIoGRAM study.  The research was fascinating, but it left me with a stronger belief that integrative medicine - and not genetics - is the future of healthcare.

You can't do a big research study without giving it a fancy name.  The big heart trials were given names like HOPE, JUPITER and TACT (our chelation therapy trial) because people remember these catchy acronyms.   The Coronary ARtery DIsease Genome-wide Replication And Meta-analysis (CARDIoGRAM) study analyzed 2.5 million bits of DNA in 87,000 people in Canada, the US, the UK and Germany.

The first major discovery that came from this research was a gene on chromosome 9 - its location is referred to as 9p21, and that's the name the gene goes by.  Although no one knows exactly what it does, people who have two copies of it have about twice the risk of having clogged arteries.  It doesn't increase the risk of heart attack, but it is being intensely studied to figure out exactly what it does.  This will help us better understand how heart attacks occur, but it may also lead to a new drug to treat heart disease.  So naturally, big pharma is excited.

But there is no single gene that causes heart disease.  After analyzing all the DNA, the research group found 36 different gene variants that were found more often in people who had heart disease than people who didn't.  The more of these you have, the more severely clogged your arteries will become and the greater your risk of having a heart attack.  It will take a least a decade and another several million dollars before this web of DNA is untangled and researchers can find something useful to do with it.

The total cost of recruiting the participants, getting their DNA, analyzing the numbers and finding these gene variants was about $200 million, making it the largest research project in the history of cardiology.  It has led to a number of innovations in terms of how researchers work together, how data is collected and interpreted, and how science can uncover the hidden secrets of nature.

But the most important discovery here was something that Dr Roberts mentioned only briefly.  The 36 genetic risk factors that were identified in these 2.5 million bits of DNA are only responsible for about 20% of a person's inherited risk of heart disease.  The other 80% of your inherited risk is not genetic.

What does that mean?  It means that what your parents choose to eat will shape your lifelong eating habits.  The more TV you watch, the more TV your children will watch.  Smokers have children who smoke more.  The way your father coped with stress will determine how much stress affects you throughout your life.  These lifestyle factors are not genetic, but they are inherited.  And their impact on your risk of heart disease - and cancer, and Alzheimer's and diabetes, and depression and arthritis and all the other diseases of chronic inflammation, degeneration and aging - is about four times greater than the impact of your genes.

The nature versus nurture debate has been going on for decades.  But scientists have wrongly assumed that your genes are the only thing you inherit from your parents.  That is a mistake that we are just beginning to understand.  A recent landmark study on social networks and obesity found that you are more likely to become fat if you have fat friends.  Their habits affect your habits and in that way we infect each other with diseases that are not considered infectious.

We are working towards establishing a Heart Program that will help patients change the way they live as part of an integrative approach to treating heart disease.  Food, exercise and stress are the three pillars of lifestyle change.  But treating toxins, biochemical imbalances and other factors with safe, natural treatments will also play a role.

You are more than your genes.  You can heal your inheritance.  Beautiful, no?

Dr. Richard Nahas