Heritability of death from coronary heart disease: a 36-year follow-up of 20 966 Swedish twins

Objective. The aim of the present study was to evaluate and distinguish between environmental and genetic effects for death from coronary heart disease (CHD) as well as to determine whether the importance of genetic influences is changing wit age. Design. A cohort study with a follow-up time of 36 years. Subjects. The cohort drawn for the present study includes 20 966 twins born in Sweden between 1886 and 1925 where both twins within a pair still lived within the country in 1961. Methods. Concordances and correlated gamma-frailty model were used to assess and distinguish between genetic and environmental influences as well as to evaluate age-related changes in genetic influences. Results. A total number of 4007 CHD-deaths (2208 males, and 1799 females) was observed. The probability of dying from CHD given that one's twin partner already has died from CHD decreased with increasing age, particularly amongst males. The genetic variation in susceptibility to death from CHD was moderately large, and decreased slightly across time, particularly amongst males. The heritability was 0.57 (95% CI, 0.45-0.69) amongst male twins, and 0.38 (0.26-0.50) amongst female twins. Conclusions. The genetic contribution to the variation in CHD-mortality was moderate both in females and males. Furthermore, although genetic effects appeared to be greater at younger ages of death, our findings clearly suggest that genetic factors are in operation throughout the entire life span.