TITLE:
Personalized Medicine in Cardiovascular Pharmacology: Advances in Pharmacogenomics and Drug Development
AUTHORS:
Murtala Audu Ngabea, Yusuff Dimeji Igbayilola
KEYWORDS:
Diabetes, Precision Medicine, Cardiovascular Therapy, Inflammation,
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.15 No.3,
August
29,
2025
ABSTRACT: With an estimated 20.5 million deaths from cardiovascular diseases (CVDs) in 2021, around 80% of these deaths will occur in low- and middle-income countries, making CVDs the leading cause of mortality worldwide. Multiple risk factors, such as chronic inflammation, oxidative stress, hyperglycemia, and hyperlipidemia, are implicated in the etiology and pathogenesis of CVD. Mitochondria, the principal sites of reactive oxygen species (ROS) production and where ATP is synthesized, are pivotal for cardiovascular pathophysiology and are now leading targets of therapy. Lifestyle modifications and diet are first addressed in CVD, but drug therapy and surgery can significantly increase how long and how well patients with CVD live. TCM, which has been used in medical settings for over 2,500 years, offers an integrative therapeutic method of treatment and has been found to be effective for the management of CVD and other chronic diseases. These integrative methods, along with pharmacogenomics, which explores how genetic diversity affects drug response, have emerged into cardiovascular medicine. Genetic polymorphisms significantly affect the safety and efficacy of numerous drugs, such as antiplatelets, anticoagulants, statins, and antiarrhythmics. Critical genetic variants in the genes CYP2C9, CYP2C19, VKORC1, and SLCO1B1 govern the response to warfarin, clopidogrel, simvastatin, and other medicines. Notably, the CYP2C19 genotype influences the pharmacokinetics and safety of mavacamate, an emerging treatment for hypertrophic cardiomyopathy. In low-resource settings, the application of pharmacogenomic testing is limited by many barriers. These are cost, the unavailability of trained scientists, limited laboratory infrastructure, and the absence of population-based genomic data. Ethical and regulatory issues—such as unclear clinical guidelines and data privacy concerns—further hinder adoption. To unlock the global potential of personalized cardiovascular therapy, strategic investment in infrastructure, inclusive genomic research, and supportive health policies are essential. With coordinated efforts, pharmacogenomics can enhance therapeutic precision and advance global health equity.