Race, Common Genetic Variation and Therapeutic Response Disparities in Heart Failure | Journal Scan

Study Questions:

What is the genetic basis for race-associated differences in heart failure pathophysiology?


Existing data are reviewed and new data are presented related to genetic variation between populations of African ancestry (AA) and European ancestry (EA) related to cell-signaling mechanisms important in heart failure.


Neurohormonal signaling mechanisms frequently (16 of the 19 investigated polymorphisms) exhibit racial differences in the allele frequencies of variants comprising key constituents.


Differences in allele frequencies related to neurohormonal signaling may affect the natural history of heart failure in AA compared with EA populations, and likely play a role in observed racial differences in drug or device response.


Variability in the response to cardiovascular therapeutics is well described and in many cases may be due to common gene variants. This concept is particularly well illustrated by the effect of race on outcomes and response to drugs used to treat heart failure. In 15 genes with established effects on heart failure pathophysiology, these authors showed that common polymorphisms (many of which appear to be functional) are markedly different between AA and EA populations. If confirmed, use of genetic data such as those described in this article could further refine individual heart failure management strategies, leading to improved outcomes.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: African Continental Ancestry Group, European Continental Ancestry Group, Gene Frequency, Heart Failure, Polymorphism, Genetic

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