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Renin–angiotensin–aldosterone system (RAAS) pharmacogenomics: implications in heart failure management

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Abstract

Blockade of the renin–angiotensin–aldosterone system (RAAS) with ACE inhibitors has been a cornerstone of heart failure therapy for over 15 years. More recently, further blockade of RAAS with aldosterone antagonists and angiotensin receptor blockers (ARBs) has been studied. While these therapies have certainly improved outcomes in the treatment of heart failure, morbidity and mortality remain extremely high. Furthermore, polypharmacy and complex regimens of seven medications on average is the norm for management of heart failure. This results in increased costs, patient burden, and uncertainty as to the best course of therapy. The ability to personalize patients’ therapeutic regimens using pharmacogenomics has the potential of providing more effective and efficient use of RAAS-modulating medications. This review highlights the implications of major RAAS pharmacogenetic studies, while outlining future directions for translation to practice.

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Acknowledgments

This work was supported in part by National Institutes of Health P50 HL077113 (ALB), GM74492 (IZ), American Heart Association Heartland Affiliate 0655496Z (ALB) and Florida/Puerto Rico Affiliate 0435278B (IZ).

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  1. Department of Pharmacy Practice and Center for Pharmacogenomics, University of Florida College of Pharmacy, PO Box 100486, Gainesville, FL, 32610, USA

    Amber L. Beitelshees & Issam Zineh

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  1. Amber L. Beitelshees
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  2. Issam Zineh
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Correspondence to Amber L. Beitelshees.

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Beitelshees, A.L., Zineh, I. Renin–angiotensin–aldosterone system (RAAS) pharmacogenomics: implications in heart failure management. Heart Fail Rev 15, 209–217 (2010). https://doi.org/10.1007/s10741-008-9092-z

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  • DOI: https://doi.org/10.1007/s10741-008-9092-z

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