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Ischaemic heart disease has both environmental and genetic influences, but research has concentrated on the environmental angle. The main modifiable risk factors have been identified and preventive measures introduced with substantial success. Our knowledge of genetic factors has yet to be established in the same ways. The idea of routine tests evaluating genetic risk factors seems appealing but it has not been feasible. Test results could not at present provide a clinician with more than confirmation of a positive family history as an indicator of increased susceptibility to the disease.
The picture has changed with recent reports that a genotype of the angiotensin converting enzyme (ACE) gene may be a risk factor for ischaemic heart disease.1 2 These studies show the potential of modern molecular biology as a research tool for establishing genetic risk factors for cardiovascular diseases. Moreover, in this case a
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