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Chronic heart failure: β-blockers and pharmacogenetics

  • Review Article
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European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The European Society of Cardiology recommends that β-blockers should be considered for treating all patients with stable, mild, moderate, or severe heart failure (HF) who are receiving standard treatment, unless there is a contraindication. Despite the significant benefit of the drug, there is widespread recognition of patient-to-patient variability in drug response. The genetic determinants of responses to drugs have important implications for the clinical course and management of HF. Pharmacogenetics (PGt) has drawn great attention for its potential to redirect personal care and public health paradigms. The aim of this review was to gather information on PGt of β-blockers in HF treatment.

Methods

We searched for articles related to PGt of β-blockers in the PubMed database and attempted to cover all related articles.

Results

Several genetic polymorphisms affecting proteins in the β-adrenergic receptor signaling pathway have been proposed as modifiers of HF risk. The most relevant of these to this review is the pharmacogenetic interactions between the genetic variants of catecholamine receptors or their effectors and β-blockade for the treatment of HF.

Conclusions

Interindividual variability of responsiveness to β-blockers can be explained by PGt data of adrenaline-related genes. To demonstrate that pharmacogenetic intervention produces successful individualized β-blocker treatment for HF patients, prospective, randomized, and pharmacogenomics (PGx)-based clinical trials are required. Our assessment is that we are already at a turning point in the history of clinical pharmacology.

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Acknowledgments

We thank Dr. Kenichi Imagawa for his stimulating discussion. This study was supported in part by Health Labour Sciences Research Grant from The Ministry of Health Labour and Welfare and Grant-in-Aid for Scientific Research from Japan Society for the Promotion of Science. This study was also supported by a grant from the Japan Research Foundation for Clinical Pharmacology.

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  1. Department of Clinical Pharmacology & Pharmacogenomics, Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamada-oka, Suita, Osaka, 565-0871, Japan

    Junichi Azuma & Shinpei Nonen

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  1. Junichi Azuma
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  2. Shinpei Nonen
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Correspondence to Junichi Azuma.

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Azuma, J., Nonen, S. Chronic heart failure: β-blockers and pharmacogenetics. Eur J Clin Pharmacol 65, 3–17 (2009). https://doi.org/10.1007/s00228-008-0566-7

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