Description
From 2019 to 2023, the national project "Development of personalised cardiovascular medicine solutions in Estonia" has been carried out, Results have been published: Viigimaa M, Jürisson M, Pisarev H, Kalda R, et al. Effectiveness and feasibility of cardiovascular disease personalized prevention on high polygenic risk score subjects: a randomized controlled pilot study. Eur Heart J Open 2022; 2, 1--10. Necessary IT infrastructure was created to bring personalised medicine into common clinical practice in Estonia. While many proof-of-principle solutions, such as polygenic risk scores and extensive pharmacogenetic testing, have been effectively demonstrated in research projects, new IT components need to be developed and deployed to the national health system to integrate them into everyday clinical practice. Estonia has recently started the new study (2025-2030), which is the first of its kind globally, and its findings could enable people to receive personalised genetic risk-based treatment to maintain their heart health. The study is highly relevant worldwide, as cardiovascular diseases are the leading cause of mortality, according to the World Health Organization. We are going to establish preventive statin therapy as a standard practice for individuals with a high genetic risk of heart disease. The study will include 2,500 Estonian gene donors aged 45--80 who meet the genetic risk criteria for heart disease. The five-year study will be conducted by the University of Tartu, Tartu University Hospital, and North Estonia Medical Centre in collaboration with the Estonian Society of Cardiology, Estonian Society of Family Doctors, and pharmacies.Program launch date
Starting 25 March 2025, the Estonian Biobank will invite selected gene donors to participate in an extensive heart health research study. The study aims to determine whether heart disease can be more effectively prevented with cholesterol-lowering treatment based on genetic risk assessment.Responsible entity
The project is supported by €15 million from the European Commission, with an equal investment from the Estonian state.Available results and quality metrics
It is known that individuals with a high genetic risk are more likely to develop heart disease, and that they experience it earlier than those with a lower genetic risk. The difference is significant -- individuals with a high genetic risk have a 91% higher chance of developing heart disease, according to the Estonian Biobank data. This study will investigate whether preventive treatment based on genetic risk is more effective in preventing heart disease than current treatment practices.Limitations / comments
Estonia is working to advance the implementation of cardiovascular precision medicine in Estonia by integrating clinical practice, genomics, IT, social sciences, and economics. Estonia is an excellent location for such studies, as a significant portion of our population are gene donors.