Cultural competence: cardiovascular medications.
Interethnic or racial differences are associated with enzyme polymorphisms, which are tiny variations in individuals in the physiology, absence, or presence of drug-metabolizing enzymes. The largest class of cardiovascular drugs investigated in pharmacogenetic studies is the antihypertensives. A number of studies have examined the best choices of antihypertensives for individuals within selected racial and ethnically defined populations. There is a fairly strong consensus about the pattern of antihypertensive treatment for black patients, but clear treatment directives for antihypertensive patients with other cultural affiliations have not emerged. Less information is reported about racial, ethnic, or cultural differences in effectiveness for other cardiovascular drugs. Nurses should consider whether the ethnic or racial affiliation of the patient places him or her more at risk for impaired drug metabolism. This article contains a guide for nursing assessment of culturally important factors related to polymorphisms.