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content of all lipids, components, and subclasses. VAP is an expanded cholesterol
profi le that provides direct, detailed measurements of cholesterol, or lipid, sub-
classes which play important roles in the development of cardiovascular disease.
The test identifi es twice the number of people at risk for heart disease than tradi-
tional cholesterol tests developed in the 1970s. Measurements obtained using.
VAP test also provide physicians with a foundation from which to develop indi-
vidualized treatment plans while continuing to track patients’ progress in battling
heart disease.
Biomarkers and Personalized Management
of Cardiovascular Disorders
The cardiovascular therapeutic area is complex and includes a number of overlap-
ping diseases. In the past, low-cost biomarkers, such as BP and cholesterol measure-
ments were used. However, they do not address issues such as plaque stability and
size. Many new biomarkers have been discovered in recent years. Many of these are
bases for diagnostic tests and there have potential uses in drug discovery and devel-
opment. There is need for better diagnostic tests including those encompassing
metabolic syndrome – a constellation of disorders including cardiovascular dis-
eases, diabetes, and obesity. Other clinical biomarkers for cardiovascular diseases
will include intravascular ultrasound, and in vivo tests for plaque composition and
stability using imaging. Biomarkers will be important for development of personal-
ized therapies for cardiovascular disorders.
Pharmacogenomics of Cardiovascular Disorders
Application of pharmacogenomics for development of personalized treatment of
cardiovascular disorders is illustrated by a few examples, such as myocardial
infarction, heart failure and hypertension, which are common conditions. The
application of pharmacogenetics to cardiovascular disease management is also dis-
cussed. Factors that may be taken into account when selecting drug therapy for a
patient with cardiovascular disease include age, race, concomitant diseases, medi-
cations, and renal and hepatic function. The renin-angiotensin system (RAS) plays
a major role in the development and progression of cardiovascular diseases by pro-
moting vasoconstriction, sodium reabsorption, cardiac remodeling, norepinephrine
release, and other potentially detrimental effects. Angiotensin-converting-enzyme
(ACE) inhibitors and angiotensin II type 1-receptor (AT1R) blockers are recom-
mended for managing cardiovascular diseases, such as hypertension, myocardial
ischemia and heart failure. However, there is substantial variability in individual
responses to these agents.
14 Personalized Management of Cardiovascular Disorders