Precision Medicine: Challenges in Utilizing Electronic Health Records in Pharmacogenomics Research

Access and utilization of electronic health records (EHR) with extensive medication lists and genetic profiles is rapidly advancing discoveries in pharmacogenomics. In this study, African American adults from the Vanderbilt University Medical Center’s biorepository (BioVU) were included in a pharmacogenetics study on the effect of antihypertensive and lipid lowering medications prior to and after initiation of medication. Among hypertensive adults (n=2,268), the average change in systolic and diastolic blood pressure was -0.6 mmHg and -0.8 mmHg, respectively. In adults on lipid lowering medication (n=1,244), the average drop in low- density lipoprotein cholesterol (LDL-C) was -26.3 mg/dL. In a genetic association analysis of percent change in blood pressure and LDL-C after initiation of medication, we did not observe a significant association after adjustment for multiple testing. The study illustrates the benefits and challenges of using EHRs linked to biorepositories for pharmacogenomic studies.