Predicting cardiovascular disease outcomes more equitably

Healthier Lives has awarded $1.3 million for new research that will use epigenetic studies to help predict risk of secondary health issues among people with heart disease and to understand the variation in responses to different therapies.

Professor Greg Jones (University of Otago) will lead the highly experienced and collaborative team of researchers and clinicians from the Universities of Otago and Auckland, and ESR, a Crown Research Institute.

Epigenetics is a new and growing area of study in disease prediction that looks at changes in our DNA that occur due to environmental factors.  In today’s world, we are all exposed to a wide variety of environmental elements and factors that influence our DNA, without changing the underlying genetic code.

These reversible changes can be read by our bodies and reflect each person’s unique past environmental history.

DNA Methylation

One type of epigenetic alteration is DNA methylation. It is a sensitive and specific marker of environmental exposures such as smoking, nutrition, exercise and stress. Certain highly specific DNA methylation patterns have been associated with heart disease, and the profiles reflect an individual’s lived experiences.

The new research will assess DNA methylation profiles or epigenetic markers against profiles of people with a history of heart attacks.

Matching markers to big data sets

The researchers will test and match the epigenetic markers to a subset of a large study called MENZACS* which includes clinical and lifestyle data, as well as information about the subsequent health outcomes following treatment for coronary heart disease.

“We’re setting out to assess DNA methylation profiles of people with a history of heart attack, in order to provide more precise, personalised and equitable prediction and prevention of metabolic conditions such as diabetes and heart disease,” says co-principal investigator Professor Vicky Cameron.

By matching the two sets information together, environmental factors plus DNA methylation, researchers will be able to understand what happens when individuals have treatment (whether medical management or lifestyle invervention) and how it has worked. The ultimate aim of this project is to identify epigentic markers to ensure each heart attack patient receives the appropriate health intervention to reduce their future risk of heart disease events.

Improving health equity

Greater diversity needs to be prioritised in genetic and epigenetic studies to ensure that health equity is increased. A quarter of the participants in the study are Māori to ensure the findings will apply equally to Māori.

The study has a kaitiaki group led by Dr Anna Rolleston (Ngati Ranginui, Ngai Te Rangi, Ngati Pukenga), which will follow the principles of Te Mata Ira – Cultural Guidelines for Biobanking and Genomic Research to provide guardianship over the data and ensure best practice.

Dr Allamanda Faatoese, who has recruited over 200 people from the Christchurch Pacific community to the Pasifika Heart Study, will be involved in analysing DNA methylation patterns from this important cohort.

*MENZACS = Multi-Ethnic New Zealand Study of Acute Coronary Syndromes

RESEARCH PROJECT TEAM

The project team consists of experts in diabetes, statistics, sample management, cardiovascular risk factors, epigenetics and bioinformatics.

Principal Investigators

• Professor Greg Jones, University of Otago
• Professor Vicky Cameron, University of Otago, Christchurch
• Dr Anna Rolleston, University of Auckland
• Professor Rob Doughty, University of Auckland
• Associate Professor Malcolm Legget, University of Auckland
• Dr Donia Macartney-Coxson, Environmental Science and Research (ESR)
• Dr Katrina Poppe, University of Auckland

Associate Investigators

• Dr Basharat Bhat, University of Otago, Christchurch
• Dr Allamanda Faatoese, University of Otago, Christchurch
• Dr Anna Pilbrow, University of Otago, Christchurch