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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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Scooped by Seth Bilazarian, MD
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Genetic risk, coronary heart disease events & benefit of statins

Genetic risk, coronary heart disease events & benefit of statins | Heart and Vascular Health | Scoop.it

Genetic variants have been associated with the risk of coronary heart disease. In this study, we tested whether or not a composite of these variants could ascertain the risk of both incident and recurrent coronary heart disease events and identify those individuals who derive greater clinical benefit from statin therapy.Specifically, in the primary prevention trials, the number needed to treat to prevent one such event in 10 years was 66 in people at low genetic risk, 42 in those at intermediate genetic risk, and 25 in those at high genetic risk in JUPITER, and 57, 47, and 20, respectively, in ASCOT.A genetic risk score identified individuals at increased risk for both incident and recurrent coronary heart disease events. People with the highest burden of genetic risk derived the largest relative and absolute clinical benefit from statin therapy.

Seth Bilazarian, MD's insight:

There has been much enthusiasm about the potential for genetic testing to predict disease. Unfortunately, this has not yet found practical utility for practicing physicians and their patients. This analysis from investigators @BrighamWomens may be a major breakthrough to permit a reasoned approach to help decide which patients should get statin therapy ( drugs like Lipitor, Crestor and simvastatin ) for cholesterol lowering.

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Scooped by Seth Bilazarian, MD
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DNA determinants of Blood Pressure Response to Antihypertensives

DNA determinants of Blood Pressure Response to Antihypertensives | Heart and Vascular Health | Scoop.it

My comment:  The personalized medicine revolution is still on the horizon. Being able to evaluate which drug would be best for a patient before trying multiple drugs would be desirable and of great benefit (less cost, less side effects) but insurance payers and guidelines have not yet caught up with this basic science.

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39 genetic association with hypertension (HTN) have been identified. This study looked at DNA characteristics (loci/SNPs) associated with HTN and blood pressure response to antihypertensive drugs (specifically the bgereically available atenolol or hydrochlorothiazide.  768 Caucasian hypertensive participants in the Pharmacogenomics Responses of Antihypertensive Responses (PEAR) study were evaluated.

Genotypes of 37 loci were obtained:  six reached nominal significance (p<0.05) and 3 were associated with atenolol BP response at p < 0.01.

The genetic score of the HCTZ BP lowering alleles was associated with response to HCTZ (p = 0.0006 for SBP; p = 0.0003 for DBP). Both risk score p values were < 0.01.

These findings suggest selected signals from hypertension GWAS may predict BP response to atenolol and HCTZ when assessed through risk scoring.

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