February is a time to keep hearts on the mind: both with Valentine’s Day on Feb. 14 and the entire 28 days being recognized as American Heart Month.
According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the U.S. among both men and women, with about 600,000 people per year dying from heart disease in the U.S. Coronary heart disease is the most common type of heart disease, the CDC reports, killing nearly 380,000 annually.
High LDL (or “bad”) cholesterol, smoking and high blood pressure are key risk factors for heart disease. The CDC says roughly half of Americans half at least one of these risk factors. For high blood pressure specifically, about seven in 10 adults use medications to treat the condition.
With these sobering figures in mind, multiple government agencies and nonprofits say maintaining good eating and lifestyle practices is essential to a healthy heart. The CDC, for example, offers these tips for protecting your heart:
- Follow your doctor’s instructions and stay on your medications.
- Eat a healthy diet that is low in salt; low in total fat, saturated fat, and cholesterol; and rich in fresh fruits and vegetables.
- Take a brisk 10-minute walk, three times a day, five days a week.
- Don’t smoke. If you smoke, quit as soon as possible.
When it comes to heart medications, research has shown that individuals’ unique DNA plays a significant role in how they respond to many of these drugs. Many such 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 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.
Both the CDC and The Heart Foundation have myriad resources available for keeping a healthy heart and reducing heart disease risk on their respective websites. Take February as an opportunity to focus on heart health.