the-aps.org>meetings>eb

Pharmacogenomics of Estrogen and Cardiovascular Disease
Sponsored by APS Cardiovascular Section
Translational Physiology Track

Individualized treatment or pharmacogenomics is here. In order to deliver the right drug at the right dose to the right person, testing for genetic variants in cytochrome P450 enzymes (2D6, 2C9, 2C19) is now available for women contemplating treatment with a selective estrogen receptor modulator (tamoxifen) as adjunct treatment for estrogen receptor positive breast cancers.   The question arises as to how this exciting new information can be translated to other estrogen-dependent diseases not only in women but in men as well as deficiencies in bioavailable estrogen is related to osteoporosis in both men and women.  Furthermore, genetic variants in estrogen receptors are also associated with accelerated cardiovascular disease in both sexes.  Because of the negative publicity associated with the early results of the Women’s Health Initiative (WHI), interest in estrogens as a treatment strategy for prevention of cardiovascular disease, and vasomotor symptoms of menopause (hot flashes) has waned.  With the ability to genotype for variation in estrogen receptors and enzymes for its metabolism, it is time to revisit the issue of estrogen as a therapy targeted toward the subset of individual who would benefit most at reduced risk for treatment.  This symposium aims to renew interdisciplinary research into how estrogen modulates cardiovascular function by bringing together experts who will review current state of knowledge of genetic variants in estrogen receptors and metabolism.  Following this basic information will be discussion of how the genetic information is being applied to evaluate the cardiovascular outcomes of large clinical trials (Hormones and Estrogen/progestin Replacement Study, HERS and the WHI) and finally how basic scientists can help facilitate and validate changes in drug prescribing and labeling practices.