New genomic research on cardiovascular health in rural North Carolina

Two genomic-based studies from Heart Healthy Lenoir were published in the last month. Heart Healthy Lenoir was a multidisciplinary research project that aimed to reduce cardiovascular disease in Lenoir County, North Carolina by developing new approaches to care, from prevention to treatment. The lead investigator of the Heart Healthy Lenoir genomics study is Jonathan Schisler, PhD, assistant professor in the Department of Pharmacology and McAllister Heart Institute.

New genomic research on cardiovascular health in rural North Carolina click to enlarge Research find genetics can impact vegetable consumption
New genomic research on cardiovascular health in rural North Carolina click to enlarge Researchers study genes and hypertension treatment

Two genomic-based studies from Heart Heathy Lenoir were published in the last month. Heart Healthy Lenoir was a multidisciplinary research project that aimed to reduce cardiovascular disease in Lenoir County, North Carolina by developing new approaches to care, from prevention to treatment. Lenoir County is largely rural and is located in the “stroke belt,” a region of the Southeastern United States that has a rate of death from stroke significantly higher than the rest of the United States. The lead investigator of the Heart Healthy Lenoir genomics study is Dr. Jonathan Schisler, Assistant Professor in the Department of Pharmacology and McAllister Heart Institute.

The first study brought together specialists in nutrition, public health, and genetics to look at how common genetic variation in our taste receptors for bitter taste (such as that found in leafy green vegetables) associates with changes in vegetable intake in a lifestyle intervention designed to promote heart health. Over half of Caucasians, and an even higher percentage of African Americans are sensitive to this bitter taste. The study participants that were non-bitter tasters increased their vegetable consumption more than the bitter tasters, though all participants in the enhanced lifestyle intervention arm increased their vegetable intake. This study may pave the way to dietary interventions that are personalized according to taste preferences. By using genetic taste receptor profiling, diets or lifestyle changes could be tailored based on genetic predisposition to taste to optimize adherence and heart health. For example, individuals who are sensitive to the bitter compounds in certain vegetables could receive tailored cooking recommendations that reduce the bitter taste in those vegetables. Lead author Dr. Larissa Calancie noted that “It is important for those designing dietary interventions to remember and acknowledge that taste preferences vary. That being said, our findings show that even those who perceive bitterness in certain vegetables can increase their vegetable intake in the context of an intervention.” More research is needed to understand how vegetable promotion strategies vary across the range of taste preferences and how genetic information could be used to help promote intervention approaches that resonate with individuals. Dr. Peter Kaufmann, Associate Dean of Research and Scholarship at the University of Colorado College of Nursing and former Deputy Chief of the Clinical Applications and Prevention Branch in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI) and the National Institutes of Health and Senior Scientist in the Center for Translation and Implementation Science at NHLBI praised this study as “perhaps the first instance in which the design of a behavioral lifestyle intervention that improves health can take into account individual differences based on a genetic marker. Moreover, this finding illustrates that if precision medicine is to become a reality, research on behavioral phenotypes is as important as research on molecular biology.”

A second publication highlights how applicable precision medicine regarding hypertension is to rural populations, such as that in the Lenoir County region. Combining experts in health services research, primary care, epidemiology, public health, and genetics, researchers identified which blood pressure-related genetic variants, identified from large clinical studies, were applicable to the study population based in this region. They also identified genetic variants that associated with how well subjects responded to a multi-level intervention developed using community participatory methods to help improve blood pressure control among African American and Caucasians who have hypertension. Lead author Dr. Jacqueline R. Halladay comments “this is the kind of effort that Center funding mechanisms can support. In our case teams from 3 different R01 grants worked collaboratively for years to perform complementary practice based, community based and genetic studies. Analyses and results like these are possible when we combine our collective data, acumen, experiences and input from relevant community stakeholders.” Chief of the Division of Cardiology and Co-Director of McAllister Heart Institute Dr. Rick Stouffer commented that this study is notable because it “applies ‘precision medicine’ to a needy population and showed that genetic data can provide important information to clinicians on how patients will respond to blood pressure medications.”