With Father’s Day approaching, what better way to celebrate the men you call family and friends than by helping to make sure they take their health seriously?
June is National Men’s Health month, a time for men everywhere to focus on the health concerns that most often impact them. For many men this means cardiovascular health, which includes controlling blood pressure, cholesterol and weight.
According to Centers for Disease Control and Prevention data, heart disease is the leading cause of death in American men, killing as many as one in four men. That makes cardiovascular disease responsible for more deaths than cancer and diabetes combined.
With heart disease such a serious issue for men, discussing the genetic underpinnings of individual differences in response to common heart medications also becomes important. These natural variations in DNA can show themselves as treatment failures or potentially deadly side effects, such as serious bleeding.
Many heart medications are processed by three enzymes in the liver known as CYP2D6, CYP2C9 and CYP2C19. These enzymes are known to be highly genetically variable, meaning different people can carry altered versions of these enzymes. If one of these enzymes is too active, you process the medication too quickly. If the enzyme is not active enough, the medication can build up in your bloodstream, potentially causing adverse reactions or side effects.
For types of medications known as prodrugs, the opposite would be true. Prodrugs need to be converted into their active form by a metabolizing enzyme for patients to benefit from them. If a prodrug-metabolizing enzyme is too active, the medication would build up to potentially toxic levels. If activity of that enzyme is reduced, not enough of that medication is converted into its active form, reducing its effectiveness.
Common heart medications that rely on these enzymes include the anti-clotting drug warfarin, also known as Coumadin, the blood thinner clopidogrel, also known as Plavix (a prodrug) and the blood pressure medication metoprolol (Lopressor). Without knowing a patient’s unique genetic makeup, a physician may need to go through months of trial-and-error prescribing to find the right drug and dose for the patient. Learn more here about how individual genetics can affect response to heart medications and many other kinds of drugs.