Pharmacogenomics, Cardiovascular drugs, Health disparities
Cardiovascular disease is the most common cause of morbidity and mortality in the United States, affecting almost 100 million adults and costing over $300 billion. Death from cardiovascular disease had been steadily declining since the 1970s due in part to remarkable advances in pharmacotherapy, but more recently has started to worsen. Although the reasons for this reversing trend are likely multifactorial, it is evident that better optimization of therapy may help to improve this recent worsening. In particular, there exists considerable interindividual variability in response to cardiovascular drugs. We hypothesize that the discovery and clinical validity of molecular biomarkers for cardiovascular disease drug response will allow clinicians more precise select cardiovascular pharmacotherapy regimens, thereby improving population-wide cardiovascular health outcomes. The overall research goal of my group is to improve pharmacological regimens for the prevention and treatment of cardiovascular disease through precision medicine. To accomplish this objective, we combine computational approaches in pharmacogenomics, pharmacometrics, and pharmacoepidemiology using electronic health record-linked biobanks. In addition, only ~14% of participants from all genome wide association studies are of non-European descent, despite accounting for ~86% of the global population. This underrepresentation has the strong potential to exacerbate health disparities. Thus, another goal of our group is to ensure that study populations of genomics research studies are inclusive so that advances can benefit all. In accord with our overall research objectives and the approaches that we employ, we are currently investigating genetic determinants of efficacy and safety for hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitor therapy in diverse populations.