|
|
|
|
|
|
|
|
|
|
By Amy Norton
NEW YORK, Mar 26 (Reuters Health) - While blood pressure drugs known as beta-blockers are sometimes prescribed to people with heart failure, new research suggests that heart failure patients with a particular genetic trait may be most likely to benefit from the drugs.
The findings come from a new avenue of research exploring how an individual's genes affect responses to disease treatments. The long-range hope is to tailor therapies to best fit individual patients.
Although the current findings do not offer a new prescription for heart failure patients, they do suggest that people with a particular variant in a gene known as ACE may do especially well on beta-blockers. The ACE, or angiotensin-converting enzyme, gene helps regulate blood circulation, and everyone has two copies--one inherited from each parent.
In a study of heart failure patients, those with two "short" versions of the ACE gene fared far better when their treatment included a beta-blocker. These gene versions are considered "short" because they lack a small piece of DNA found in the "long" ACE gene.
The findings are published in the March 27th issue of Circulation: Journal of the American Heart Association.
Dr. Dennis M. McNamara and his colleagues at the University of Pittsburgh in Pennsylvania followed more than 300 men and women with heart failure, a progressive disease in which the heart cannot pump enough blood to the rest of the body. The underlying causes include past heart attacks, high blood pressure and diabetes.
People with two short versions of the ACE gene do not appear to be at higher risk for heart failure, but when they get the disease they tend to do more poorly, McNamara explained in an interview with Reuters Health. Drugs called ACE inhibitors are prescribed to most heart failure patients.
But patients with two short versions of the ACE gene have the highest level of ACE activity, which makes the heart work harder and deteriorate more rapidly. McNamara's team looked at whether beta-blockers might help their prognosis over 2 years.
The investigators found that among patients with two short ACEs, those on beta-blockers did far better than those not taking the drugs: 72% were alive after 2 years, compared with only half of those not on beta-blockers.
Beta-blockers made no difference among patients with either two long ACE genes or one of each version. About 32% of patients had two short ACE genes, 21% had two long ACE genes and 47% had one of each.
"I'm not ready to suggest we should do genetic testing today to see who should get beta-blockers," McNamara said. Larger studies will be needed before patients are either given or excluded from receiving beta-blockers based on their genes, he noted.
But, he said, "I think it's coming."
An expert not involved in the study agreed that determining which genes affect patients' responses to different heart disease treatments is the wave of the future.
"I think that's where the future is, in tailoring therapies," Dr. Dan M. Roden of Vanderbilt University in Nashville, Tennessee, told Reuters Health in an interview.
But, he noted, doctors will not start genetically screening patients based on relatively small studies such as the current one.
"What the best genetic test is, and what the best treatment is will get complicated," Roden said. But as a beginning, he noted, this study is "very provocative and very exciting."
SOURCE: Circulation 2001;103.
| Health Topics | Drug Information | Dictionaries | Directories | Other Resources |
|
U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894
Copyright and Privacy Policy, We welcome your comments. Last updated: 27 March 2001 |