Byars SG, Huang QQ, Gray L-A, Bakshi A, Ripatti S, Abraham G, et al. (2017) Genetic loci associated with coronary artery disease harbor evidence of selection and antagonistic pleiotropy. PLoS Genet 13(6): e1006328. https://doi.org/10.1371/journal.pgen.1006328 (Open access)
Author summary: How genetic variation contributes to disease is complex, especially for those such as coronary artery disease (CAD) that develop over the lifetime of individuals. One of the fundamental questions about CAD––whose progression begins in young adults with arterial plaque accumulation leading to life-threatening outcomes later in life––is why natural selection has not removed or reduced this costly disease. It is the leading cause of death worldwide and has been present in human populations for thousands of years, implying considerable pressures that natural selection should have operated on. Our study provides new evidence that genes underlying CAD have recently been modified by natural selection and that these same genes uniquely and extensively contribute to human reproduction, which suggests that natural selection may have maintained genetic variation contributing to CAD because of its beneficial effects on fitness. This study provides novel evidence that CAD has been maintained in modern humans as a by-product of the fitness advantages those genes provide early in human lifecycles.
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isn’t there a simpler version of the answer more plausible?
CAD manifests itself in later stages of life, usually well beyond the reproductive years of most individuals, and certainly beyond the reproductive years of women. there is simply very little opportunity for selection to act in regards to life history events that take place so far beyond the reproductive years.
As far as I know, but I am not up to date with the literature, in human females survival beyond reproductive age is likely to increase fitness (through care for the offspring and the offsping’s offspring). If this is true then CAD would affect fitness even at an older age.