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Mapping the genetic landscape of eight common cardiovascular diseases

Romero, C.; Wightman, D. P.; Jurgens, S.; van Walree, E.; Corver, M.; Haydarlou, P.; Schipper, M.; Bezzina, C.; Posthuma, D.; van der Sluis, S.

2026-04-27 genetic and genomic medicine
10.64898/2026.04.26.26351760 medRxiv
Show abstract

Cardiovascular diseases (CVDs) frequently co-occur, yet the shared genetic basis of cardiovascular multimorbidity remains unclear. We analysed common- and rare-variant genetic overlap across eight major CVDs using genome-wide and exome-wide association data from [~]1.7 million individuals in European and East Asian biobanks. Fifteen CVD pairs showed significant genetic correlations, with shared common-variant covariance explaining a modest proportion of phenotypic comorbidity. Genomic structural equation modelling identified three latent genetic clusters, while pleiotropic loci and genes frequently spanned cluster boundaries. Prioritised genes converged on atherosclerosis-related processes, myocardial structural and electrical programmes, and vascular-wall biology. In conditional analyses, body composition and metabolic traits consistently attenuated shared genetic liability, whereas circulating biomarkers showed smaller effects. For adequately powered traits, common-variant architecture was broadly similar between European and East Asian ancestries. These results define a shared genetic framework for cardiovascular multimorbidity centred on systemic risk factors and vascular biology.

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