As I welcome you to the pages of the latest issue of our journal, which features articles on various areas of pharmacogenetics, including those related to patients with cardiovascular diseases, in my message as Editor-in-Chief I would like to focus on one of the most dynamically developing and clinically significant fields — pharmacogenetics in cardiology. Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, and despite advances in treatment, standardized evidence-based approaches often fail to account for individual patient characteristics, primarily genetic ones. It is here that personalized medicine, which utilizes genetic information to optimize therapy, comes to the forefront.

As a recent extensive review in Arteriosclerosis, Thrombosis, and Vascular Biology (Sanghvi et al., 2025) [1] eloquently demonstrates, the integration of genomics into routine cardiology practice is already changing the paradigm of patient care. Pharmacogenetics has ceased to be a domain of purely academic interest and has become a powerful tool for enhancing the efficacy and safety of widely prescribed medications.

In this context, three pillars of cardiovascular pharmacogenetics can be identified:

Challenges and Prospects

Despite the obvious successes, serious challenges lie ahead.

First, the gap between guidelines and actual clinical practice must be bridged.

Second, the issue of representativeness is acute: most pharmacogenetic studies have been conducted on populations of European descent, which limits the applicability of their findings to other ethnic groups. This is particularly relevant for Russia as a multinational state. We must actively work to include diverse populations in research.

Third, pharmacogenetics is only one part of a broader genomic landscape. Data from genome-wide association studies (GWAS) are opening opportunities for identifying new pharmacogenetic markers.

Conclusion

It appears that pharmacogenetics is experiencing its heyday in cardiology. It provides us with concrete tools to make the prescription of both "standard" and "innovative" drugs more precise and safer. Our shared task as scientists, clinicians, and regulators is to ensure the seamless integration of this knowledge into everyday practice, making personalized cardiology accessible and effective for every patient.