Doctoral defence: Hanna Maria Kariis "Improving pharmacotherapy outcomes in psychiatric and cardiovascular conditions"

On 3 November at 13:00, Hanna Maria Kariis will defend her doctoral thesis "Improving pharmacotherapy outcomes in psychiatric and cardiovascular conditions" for obtaining the degree of Doctor of Philosophy in Gene Technology.

Supervisors:

Professor Lili Milani, PhD
Estonian Genome Center, Institute of Genomics, University of Tartu
Tartu, Estonia

Associate Professor Kelli Lehto, PhD
Estonian Genome Center, Institute of Genomics, University of Tartu
Tartu, Estonia

Dr. Maris Alver, PhD
Estonian Genome Center, Institute of Genomics, University of Tartu
Tartu, Estonia

Opponent:

Associate Professor Aleksi Tornio, MD, PhD
Institute of Biomedicine, University of Turku, and
Turku University Hospital
Turku, Finland

Summary:

People with depression face higher risks of cardiovascular disease and mortality. Although treatment for high blood pressure and cholesterol is available, only about half of patients take them as prescribed – a behaviour described as adherence and persistence. Low CVD medication adherence increases CVD risk, while side effects often cause people to stop psychiatric treatment, slowing recovery.

This thesis explores genetic influences on CVD medication adherence and persistence as well as antidepressant side effects. Namely, statin use in EstBB and FinnGen biobanks, blood pressure medication use in people with depression, and antidepressant side effects.

Statin adherence in Estonia was low compared to Finland. Genetic factors had limited influence, but higher polygenetic risk for CVD, which sums up many small risk effects, increased statin use, while polygenetic risk to psychiatric conditions reduced it. Pharmacogenes affecting drug processing did not explain the use of CVD and cancer medications. Depression and its polygenetic risk were linked to lower blood pressure medication use, encouragingly adherence improved when depression was treated.

Variation in pharmacogene CYP2C19 notably influenced side-effect burden: poor metabolisers had 50% more, ultrarapid metabolisers 17% fewer. Genetic risk for psychiatric and cardiometabolic traits increased the likelihood of side effects like weight gain, palpitations, and blood pressure increase. Furthermore, people genetically predisposed to headaches were more likely to get headaches on sertraline.

The findings suggest that polygenic and pharmacogenetic information can help assess the risk of antidepressant side effects but may not strongly predict CVD medication use. The treatment of depression could improve adherence to blood pressure medications.

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Zoom: https://ut-ee.zoom.us/j/91423849666?pwd=Rq3pTKcuJCb0rJoXA2dNEHQ8rbht7i.1
Meeting ID: 914 2384 9666
Passcode: 824333