[Genetic biomarkers and personalized medicine: application in cardiovascular pharmacology]

Not all patients respond to drug therapy in a uniform and beneficial fashion. The goal of this article is to describe the contribution of genetic variation to drug response, with a focus on drugs used in cardiovascular therapy. The rapid development of techniques in the area of genome analysis has facilitated identification of new pharmacogenomic biomarkers that can provide predictive tools for improvement of drug response and fewer incidence of adverse drug reactions. Such biomarkers mainly originate from genes encoding drug-metabolizing enzymes, drug transporters, drug targets and human leukocyte antigens. However, despite significant progress in pharmacogenomic research, only a few drugs require a pharmacogenetic test before prescription. Among the several gaps that limit the application of pharmacogenetics, it deserves to be mentioned the complex nature of drug response, that makes difficult to disentangle the interplay between genetics and environment leading to pharmacological phenotype. We have to spare no effort in the identification of genetic biomarkers related to the pathogenesis of the diseases and therapeutic targets. It may help clinicians to individualize dosing drug regimen, maximize drug efficacy and enhance drug safety with certain drugs and populations at risk.