As previously noted, markers of inflammation are very helpful in the prevention of cardiovascular disease. What about genetic tests? In evaluating a test, I ask several questions:

  1. Is the potential benefit worth the cost of the test? For example, if the test costs $400, I have to weigh it against VitalSigns’ premium behavior change program.
  2. Could it lead to harm? The PSA test, which screens for prostate cancer, is under scrutiny for causing too many prostate biopsies and prostate surgeries related to saved lives. Critics therefore argue that on balance it causes harm.
  3. Can I act on the result in a way which makes a difference to my patient and wouldn’t be part of standard therapy without the test? If the recommendation coming from the test is something we would advise anyway such as increasing exercise and improving diet or “controlling blood sugar”, the test is not helpful. If, on the other hand, it gives me insight into which specific diet or therapy works best, the test can be very helpful.

While further study is required, some of the currently available genetic tests such as KIF6, Interleukin 1, 9P21 and ApoE show promising signs of being helpful in our preventive efforts. I will share some specifics on Friday.