Abstract
This chapter introduces key concepts related to drug metabolism and disposition in the setting of common cardiovascular diseases and drugs used to treat these conditions. The burden of disease and prevalence of cardiovascular drugs prescribed are substantial. Several factors impact drug metabolism in this population, including the disease itself and its associated comorbidities, such as hepatic and kidney dysfunction, along with physiologic changes in aging, and pharmacogenetic factors. Common cardiovascular diseases reviewed include heart failure, cardiac arrest, hypertension, acute coronary syndromes, thromboembolism, and dyslipidemia. Drug classes highlighted in this chapter include: diuretics, antihypertensives, antiarrhythmics, antiplatelets, anticoagulants, and lipid-modifying agents. The therapeutic complexity, potency, and narrow therapeutic index for several drugs also mandate special attention to factors which could alter metabolism and clinical response. In summary, recognition of factors that alter the metabolism of drugs used in cardiovascular disease is critical to making appropriate adjustments in therapy to optimize outcome.
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