In many cases, cholesterol lowering medications like statins and blood pressure controlling drugs like Beta Blockers and ARBs (Angiotensin II Receptor Blockers) are prescribed to manage these chronic cardiovascular conditions. However, not all medications are suitable for everyone. This is where pharmacogenomics (PGx) testing comes in, providing personalized recommendations for the best statin or blood pressure medication based on a person’s unique genetic makeup.
Pharmacogenomics is the study of how an individual’s genetic profile may affect their response to medications. A PGx lab test involves collecting an easy cheek swab sample for the purpose of analyzing a person’s DNA to identify genetic variants that may affect how their body processes certain drugs. By analyzing a patient’s genetic profile, doctors can personalize prescribed drugs based on an individual’s genes to increase the likelihood of a good treatment outcome while diminishing the risk of side effects.
As an example, there are seven categories of statin drugs available in the United States: Atorvastatin (Lipitor®), Fluvastatin (Lescol®), Lovastatin (Mevacor® or Altoprev™), Pitavastatin (Livalo® or Zypitamag®), Pravastatin (Pravachol), Rosuvastatin (Crestor® or Ezallor Sprinkle®), and Simvastatin (Flolipid® or Zocor). These medicines are prescribed to help people lower cholesterol, but approximately only 43% of Americans taking a statin achieve LDL cholesterol goal values. Moreover, statin users may experience unwanted symptoms. Mild side effects of statins include headache, nausea, dizziness, gas, diarrhea, constipation, and achy muscles or joints. More severe side effects of statins may include confusion, memory loss, kidney damage, liver damage, significant muscle problems, and type 2 diabetes or high blood sugar. PGx testing can identify individuals who are at increased risk for side effects and help physicians recommend a statin that is less likely to cause adverse reactions. Equally important, a PGx test can flag statin drugs that may be less likely to help an individual achieve treatment goals.
Similarly, blood pressure medications can have varying effects on different individuals. People on blood pressure medications like Atenolol (Tenormin®), Bisoprolol (Zebeta®), Carvedilol (Coreg®), Labetalol (Normodyne®, Trandate®), Metoprolol (Lopressor®), Nebivolol (Systolic®), Propranolol (lnderal®), and Timolol (Timoptic®) may experience common beta blocker side effects such as anxiety, cold hands and feet, depression, difficulty sleeping or strange dreams, dizziness, dry mouth, dry skin, dry eyes, gastrointestinal effects (such as nausea, diarrhea, or constipation), headache, slowing of your heartbeat, shortness of breath, sexual dysfunction or low libido, tiredness or fatigue, and weight gain. Severe beta blocker side effects may include a very slow or irregular heartbeat, difficulty breathing or wheezing, or significant fluid retention or swelling. People on blood pressure medications like Azilsartan (Edarbi®, Edarbyclor®), Candesartan (Atacand®), Eprosartan (Teveten®), lrbesartan (Avapro®), Losartan (Cozaar®, Hyzaar®), Olmesartan (Benicar®), Telmisartan (Micardis®), and Valsartan (Diovan®, Entresto®) may experience common ARB drug side effects such as headache, fainting, dizziness, fatigue, respiratory symptoms, vomiting and diarrhea, back pain, leg swelling, and high potassium levels. In more severe cases, some people taking an ARB may have liver failure, kidney failure, angioedema (tissue swelling), lower white blood cell (WBC) counts, or irregular heartbeat caused by high blood potassium levels. PGx testing can identify individuals who are at increased risk for side effects from beta blockers or ARB drugs and recommend a blood pressure medication that is less likely to cause adverse reactions.
Statins, blood pressure lowering drugs and other heart medicines help millions of people, but finding the right drug and dosage can take a long time using the typical protocol of trial-and-error prescribing. With this methodology, patients try different options over an extended period of time to find the right balance of benefits and unwanted side effects.
Fortunately, there’s an alternative to this “throwing darts at a dartboard” process. 4U Health’s Cardiac Medication Response Test is a cutting edge pharmacogenomic (PGx) DNA test that analyzes 13 specific genes in your body known to impact the usefulness of 40+ heart health focused medications. Share your report with your doctor to help get prescribed the best drugs and dosages based on your unique genetic profile.
PGx test results score drugs into three categories:
- Green: Standard Precautions
- Yellow: Use With Caution
- Red: Consider Alternatives
You will also learn how you metabolize each medicine:
- Poor metabolizer: Reduced or no enzyme activity, which could lead to higher drug concentrations in the body and an increased risk of side effects.
- Intermediate metabolizer: Reduced enzyme activity, potentially leading to increased drug concentrations and a higher risk of side effects compared to normal metabolizers.
- Normal (extensive) metabolizer: Typical enzyme activity and a standard drug response.
- Rapid metabolizer: Increased enzyme activity, which could result in lower drug concentrations and potentially reduced drug efficacy.
- Ultrarapid metabolizer: Significantly increased enzyme activity, leading to very low drug concentrations and a high risk of treatment failure.
In conclusion, pharmacogenomic testing can be a valuable tool for doctors when selecting statin or blood pressure medications for their patients. By analyzing your genetic makeup, your doctor can tailor treatment plans that are specific to your DNA, possibly improving treatment outcomes and reducing the risk of side effects and adverse reactions.
