Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study

This study assesses the feasibility of collecting genetic samples and self-reported outcome measures after cardiovascular risk assessment, and presenting the genetic test results to participants. Coronary heart disease (CHD) genetic tests are increasingly available through direct-to-consumer market...

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Main Authors: Qureshi, Nadeem, Kai, Joe, Middlemass, Jo, Dhiman, Paula, Cross-Bardell, Laura, Acharya, Jayshree, Li, Ka Wan, Humphries, Steve E., Standen, Penny
Format: Article
Published: Cambridge University Press 2015
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Online Access:https://eprints.nottingham.ac.uk/41277/
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author Qureshi, Nadeem
Kai, Joe
Middlemass, Jo
Dhiman, Paula
Cross-Bardell, Laura
Acharya, Jayshree
Li, Ka Wan
Humphries, Steve E.
Standen, Penny
author_facet Qureshi, Nadeem
Kai, Joe
Middlemass, Jo
Dhiman, Paula
Cross-Bardell, Laura
Acharya, Jayshree
Li, Ka Wan
Humphries, Steve E.
Standen, Penny
author_sort Qureshi, Nadeem
building Nottingham Research Data Repository
collection Online Access
description This study assesses the feasibility of collecting genetic samples and self-reported outcome measures after cardiovascular risk assessment, and presenting the genetic test results to participants. Coronary heart disease (CHD) genetic tests are increasingly available through direct-to-consumer marketing, but their potential clinical impact on cardiovascular risk assessment is unclear. Observational study in 10 British general practices in Central England. A total of 320 individuals, who had completed conventional cardiovascular risk assessment, were offered CHD genetic test, with follow-up outcome questionnaire at eight months for lifestyle change and State-Trait Anxiety. A total of 119 (37%) participants returned genetic test specimens, with over a third reporting family history of CHD in a specified relative; 79 (66.4%) were categorized above-average risk on conventional cardiovascular risk assessment, 65 of whom (82.3%) were only average risk on genetic assessment. The dietary fat questionnaire was poorly completed while study participation was not associated with increased anxiety (mean increase in anxiety score=2.1; 95% CI −0.1–4.3; P=0.06). As a feasibility study, over a third of individuals offered genetic testing in primary care, as part of CVD risk assessment, took up the offer. Although intervention did not appear to increase anxiety, this needs further evaluation. To improve generalizability and effect size, future studies should actively engage individuals from wider socio-economic backgrounds who may not have already contemplated lifestyle change. The current research suggests general practitioners will face the clinical challenge of patients presenting with direct-to-consumer genetic results that are inconsistent with conventional cardiovascular risk assessment.
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spelling nottingham-412772020-05-04T20:06:36Z https://eprints.nottingham.ac.uk/41277/ Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study Qureshi, Nadeem Kai, Joe Middlemass, Jo Dhiman, Paula Cross-Bardell, Laura Acharya, Jayshree Li, Ka Wan Humphries, Steve E. Standen, Penny This study assesses the feasibility of collecting genetic samples and self-reported outcome measures after cardiovascular risk assessment, and presenting the genetic test results to participants. Coronary heart disease (CHD) genetic tests are increasingly available through direct-to-consumer marketing, but their potential clinical impact on cardiovascular risk assessment is unclear. Observational study in 10 British general practices in Central England. A total of 320 individuals, who had completed conventional cardiovascular risk assessment, were offered CHD genetic test, with follow-up outcome questionnaire at eight months for lifestyle change and State-Trait Anxiety. A total of 119 (37%) participants returned genetic test specimens, with over a third reporting family history of CHD in a specified relative; 79 (66.4%) were categorized above-average risk on conventional cardiovascular risk assessment, 65 of whom (82.3%) were only average risk on genetic assessment. The dietary fat questionnaire was poorly completed while study participation was not associated with increased anxiety (mean increase in anxiety score=2.1; 95% CI −0.1–4.3; P=0.06). As a feasibility study, over a third of individuals offered genetic testing in primary care, as part of CVD risk assessment, took up the offer. Although intervention did not appear to increase anxiety, this needs further evaluation. To improve generalizability and effect size, future studies should actively engage individuals from wider socio-economic backgrounds who may not have already contemplated lifestyle change. The current research suggests general practitioners will face the clinical challenge of patients presenting with direct-to-consumer genetic results that are inconsistent with conventional cardiovascular risk assessment. Cambridge University Press 2015-11 Article PeerReviewed Qureshi, Nadeem, Kai, Joe, Middlemass, Jo, Dhiman, Paula, Cross-Bardell, Laura, Acharya, Jayshree, Li, Ka Wan, Humphries, Steve E. and Standen, Penny (2015) Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study. Primary Health Care Research and Development, 16 (6). pp. 607-617. ISSN 1477-1128 coronary heart disease genetic testing risk assessment http://dx.doi.org/10.1017/S1463423615000122 doi:10.1017/S1463423615000122 doi:10.1017/S1463423615000122
spellingShingle coronary heart disease
genetic testing
risk assessment
Qureshi, Nadeem
Kai, Joe
Middlemass, Jo
Dhiman, Paula
Cross-Bardell, Laura
Acharya, Jayshree
Li, Ka Wan
Humphries, Steve E.
Standen, Penny
Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title_full Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title_fullStr Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title_full_unstemmed Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title_short Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
title_sort comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study
topic coronary heart disease
genetic testing
risk assessment
url https://eprints.nottingham.ac.uk/41277/
https://eprints.nottingham.ac.uk/41277/
https://eprints.nottingham.ac.uk/41277/