Ethnic Differences in Cardiovascular Drug Response

Johnson, Julie A.

doi:10.1161/circulationaha.107.704023

Cited by 179 publications

(100 citation statements)

References 79 publications

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“…Further clinical research to investigate the effectiveness of heart failure medications in different groups of patients across the world should be supported. 135 Long-term patient management is as important as diagnosis and treatment Diagnosis and initial treatment mark only the start of the healthcare journey for a patient with heart failure. Guidelines recommend a seamless transition to a management programme for long-term care that incorporates follow-up, monitoring and support.…”

Section: The Need To Apply Best Practicementioning

confidence: 99%

Heart failure: preventing disease and death worldwide

et al. 2014

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Executive Summary Heart failure is a life-threatening disease and addressing it should be considered a global health priority. At present, approximately 26 million people worldwide are living with heart failure. The outlook for such patients is poor, with survival rates worse than those for bowel, breast or prostate cancer. Furthermore, heart failure places great stresses on patients, caregivers and healthcare systems. Demands on healthcare services, in particular, are predicted to increase dramatically over the next decade as patient numbers rise owing to ageing populations, detrimental lifestyle changes and improved survival of those who go on to develop heart failure as the final stage of another disease. It is time to ease the strain on healthcare systems through clear policy initiatives that prioritize heart failure prevention and champion equity of care for all. Despite the burdens that heart failure imposes on society, awareness of the disease is poor. As a result, many premature deaths occur. This is in spite of the fact that most types of heart failure are preventable and that a healthy lifestyle can reduce risk. Even after heart failure has developed, premature deaths could be prevented if people were taught to recognize the symptoms and seek immediate medical attention. Public awareness campaigns focusing on these messages have great potential to improve outcomes for patients with heart failure and ultimately to save lives.

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Section: The Need To Apply Best Practicementioning

confidence: 99%

Heart failure: preventing disease and death worldwide

et al. 2014

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“…[3][4][5][6] ETHNIC DIFFERENCES IN HYPERTENSION-RELATED TRAITS Antihypertensive drug response Racial or ethnic differences in response to antihypertensive therapies have been widely recognized during the past decades. 10 In the early 1980's, clinical differences in response to the BP-lowering effects of b-blockers and diuretics were noted between whites (those of European descent) and blacks (those of African descent) based on several reports including a Veterans Administration Cooperative Trial, 11 which suggested that whites had a better antihypertensive response to b-blockers than blacks, whereas blacks had a slightly better response to diuretics than whites. Accordingly, in 1988, the fourth report of the Joint National Committee on the Detection, Evaluation and Treatment of High BP recommended consideration of race/ethnicity when selecting antihypertensive therapy.…”

Section: Introductionmentioning

confidence: 99%

“…12 In 2004, a meta-analysis of 15 clinical trials that had been published between 1984 and 1998 showed that there were consistent, although modest, differences in responses between whites and blacks as depicted in Figure 1. 10,13 In general, it appears that blacks respond more favorably to diuretics or calcium channel blockers, whereas whites respond to all classes of antihypertensive drugs similarly. Among Asians and Hispanics, limited data are available on the corresponding antihypertensive drug response, in regard to ethnic comparison with whites.…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in genetic predisposition to hypertension

Kato

2012

Hypertens Res

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Recently, large-scale meta-analyses of genome-wide association (GWA) studies have identified a number of loci significantly associated with systolic and/or diastolic blood pressure (BP). Most of the GWA studies reported to date were conducted in populations of European descent. Given the appreciable ethnic differences in clinical presentation of hypertension, studies in non-European populations allow us to assess the relevance of the findings in Europeans to other ethnic groups and to potentially discover novel variants. Before the GWA scan era, the presence of racial or ethnic differences has been widely recognized for response to antihypertensive therapies, salt sensitivity and impact of obesity on developing hypertension. Despite a limited number of genetic loci that have been proven to show substantial ethnic differences, we can assume four possible genetic mechanisms-(1) absence of target variants in other ethnic groups; (2) presence of allelic heterogeneity; (3) difference in linkage disequilibrium structure; and (4) gene-gene and gene-environment interactions. Considering such a number of potential sources of heterogeneity, we should be cautious about claiming the presence of genuine ethnic differences in genetic susceptibility to BP-related traits or hypertension. Approximately a quarter of BP-associated loci that have been reported in four meta-analyses of GWA studies (i.e., 8 out of 34 loci) appear to be common across three ethnic groups-Europeans, east Asians and south Asians. 'Transethnic' BP meta-analysis will be useful not only for revealing novel susceptibility loci and pathophysiological pathways but also for facilitating the fine mapping of common causal variants.

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“…The study of African population structure is also critical for reconstructing patterns of African ancestry among African Americans and for enabling genome-wide association mapping of complex disease susceptibility and pharmacogenomic response in African-American populations (6)(7)(8)(9).…”

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confidence: 99%

Genome-wide patterns of population structure and admixture in West Africans and African Americans

Bryc

Auton

Nelson

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

433

417

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Quantifying patterns of population structure in Africans and African Americans illuminates the history of human populations and is critical for undertaking medical genomic studies on a global scale. To obtain a fine-scale genome-wide perspective of ancestry, we analyze Affymetrix GeneChip 500K genotype data from African Americans ( n = 365) and individuals with ancestry from West Africa ( n = 203 from 12 populations) and Europe ( n = 400 from 42 countries). We find that population structure within the West African sample reflects primarily language and secondarily geographical distance, echoing the Bantu expansion. Among African Americans, analysis of genomic admixture by a principal component-based approach indicates that the median proportion of European ancestry is 18.5% (25th–75th percentiles: 11.6–27.7%), with very large variation among individuals. In the African-American sample as a whole, few autosomal regions showed exceptionally high or low mean African ancestry, but the X chromosome showed elevated levels of African ancestry, consistent with a sex-biased pattern of gene flow with an excess of European male and African female ancestry. We also find that genomic profiles of individual African Americans afford personalized ancestry reconstructions differentiating ancient vs. recent European and African ancestry. Finally, patterns of genetic similarity among inferred African segments of African-American genomes and genomes of contemporary African populations included in this study suggest African ancestry is most similar to non-Bantu Niger-Kordofanian-speaking populations, consistent with historical documents of the African Diaspora and trans-Atlantic slave trade.

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Ethnic Differences in Cardiovascular Drug Response

Cited by 179 publications

References 79 publications

Heart failure: preventing disease and death worldwide

Heart failure: preventing disease and death worldwide

Ethnic differences in genetic predisposition to hypertension

Genome-wide patterns of population structure and admixture in West Africans and African Americans

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