Cardiovascular Pharmacogenomics.

Pharmacogenomics is a field aimed at understanding the genetic contribution to inter-patient variability in drug efficacy and toxicity. The promise of pharmacogenomics is that it will allow for individualized therapy based on a person's genetic makeup, allowing for the selection of the drug that is likely to be the most effective with minimal risk of toxicity. Pharmacogenomics can also be used to help guide the drug discovery process, although this is not discussed in this chapter. This chapter describes the various manners in which pharmacogenomics might be used in the treatment of cardiovascular disease, including those whose treatment is by trial-and-error (like hypertension), and those whose treatment is protocol-driven (like heart failure or myocardial infarction). The current literature on genetic associations with efficacy and toxicity of cardiovascular drug response is reviewed. The approaches to pharmacogenomics research are also reviewed, including a candidate gene-driven approach and genomic approaches. There is discussion of how the approaches to date, usually single-candidate gene, must become more sophisticated in order to better understand the genetic basis for variable drug response. There is also extensive discussion of the various laboratory approaches that are essential to pharmacogenomics, including a number of different polymorphism genotyping methods. Pharmacogenomics holds great promise for enhancing our understanding of cardiovascular drug response and allowing for individualized therapy. There will be substantial work in this field in the coming years, which will hopefully lead to the point of individualization of cardiovascular drug therapy in patients. [ABSTRACT FROM AUTHOR]