Cardiovascular disease (CVD) is one of the leading causes of death not just in American society but globally. Millions of people die every year from various forms of heart disease, two of the more common ones being hypertension and atherosclerosis. Because it is such a major health problem in modern society, much research has been and is being done to find ways to help treat the symptoms and causes of the disease, to help find ways to prevent people from developing heart disease, and to understand the genetic and epigenetic causes behind the disease. However, what Dan Yang and Zhihua Liu discuss in their paper is the necessity of looking at CVD in an evolutionary context if we are to be able to more comprehensively understand CVD and how to treat it the most effectively.

One of the biggest factors that contributes to CVD in humans that Yang and Liu point out is that we are currently experiencing an evolutionary mismatch with our environment. That is, our diet and lifestyle in modern society is very different from what it was as recently as 10,000 years ago. We now eat more food (much of which is modified from its natural state), have a much more sedentary lifestyle, are under more/different types of social and psychological pressures, and engage in many more harmful activities (smoking, alcohol consumption, etc.). All of these are risk factors for CVD, and most are the result of our society evolving faster than natural selection can act. As a result, our genetic makeup is not suited to deal with many of these aspects of modern society, which leaves us susceptible to CVD.

Yang and Liu then discuss what this perspective means for the future of researching CVD. A lot of research is focused on the genetic (and epigenetic) causes of CVD, and manipulating genetic and epigenetic factors can have a lot of downstream effects that might not be anticipated. Therefore they urge researchers to keep in mind the evolutionary context and purpose of the genes that are being manipulated, because otherwise genetic manipulation can end in disaster.

I found this article very interesting, because CVD is of personal interest but also because it is a very complicated form of disease. We can and should do a lot of investigating into the mechanics of CVD, but if we don’t understand why it occurs (which means understanding the evolutionary context of the disease and the history and purpose of the genes that are involved in it) then we can’t treat and prevent it in the most effective manner – the obvious goal of researchers and physicians. Their optimism about evolutionary medicine becoming a mainstream science was encouraging, and hopefully we will see more of this type of research in the coming years.