New research revealed that a gene variant carried by about
40 percent of African-Americans protects them after heart failure as much as
widely used beta-blocker drugs do.
The findings could explain why clinical trials of the drugs
have shown little benefit to African-American patients.
“To our knowledge, this is the first case where a genetic
variant mimics the activity of a drug used to treat a disease,” said Dr.
Stephen B. Liggett, a professor of medicine and physiology at the
Heart failure, a condition caused by a number of diseases including diabetes and hypertension, results in inefficient blood pumping from the heart to the rest of the body. During the crisis, the body releases adrenaline to keep the organ pumping. Too much adrenaline overworks the heart, and eventually the organ gives out. Beta-blockers are specially designed to block adrenaline receptors and slow the heart rate.
Researchers at the
People with the variant gene could be said to have a natural beta-blocker. A study of 375 black adults with heart failure showed that among those not taking beta blockers, those with the GRK5-Leu41 variant lived twice as long as those with the more common variant. The same prolonged survival was seen in those with the normal variant who took beta-blockers. Beta-blocker therapy did not increase the survival of individuals with the helpful gene variant.
“That doesn't mean African-Americans
with heart failure need to be tested for the genetic variant to decide whether
to take beta blockers. Under the supervision of a cardiologist, beta blockers
have very low risk but huge benefits, and I am comfortable prescribing them to
any heart failure patients who do not have a specific contraindication to the
drug,” says senior author Gerald W. Dorn II, M.D., professor of medicine,
associate chairman for translational research and director of the Center for
Pharmacogenomics at
He further adds: “These results offer an explanation for the confusion that
has occurred in this area since clinical trials of beta blockers began. Our
study demonstrates a mechanism that should lay to rest the question about
whether beta blockers are effective in African-Americans -- they absolutely are
in those who don't have this genetic variant.”
About 5 million people in the
The study, funded by the National Heart, Lung, and Blood Institute, appeared online in the April 20 issue of Nature Medicine.