Another Kind of Precision Medicine
When we think of precision medicine, we are usually considering individual treatments. Precision medicine is usually individualized medicine. For example, an evaluation of the genes in a cancer shows which ones are abnormally activated or mutated to guide specific treatment for an individual. If the gene for the epidermal growth factor is switched on in lung cancer, an antibody against that gene is precision treatment.
There is another kind of precision medicine. If an individual is eating fast food, processed food, and has increased abdominal fat, that person always makes increased angiotensin II and aldosterone. The enzyme (HMG Co A) that increases cholesterol production is increased as are molecules that promote inflammation. Angiotensin II, aldosterone, and HMG CoA reductase all increase oxidant production to switch on the master metabolic switch mTOR and switch off AMPK. These changes are all very predictable and they can be blocked precisely.
Losartan blocks angiotensin II effects like a laser. Statins block HMG Co A. Eplerenone blocks aldosterone. Metformin and empagliflozin switch on AMPK and switch off mTOR. Diet and exercise can do the same thing. Taken together these are precision interventions that block the core biology that causes people with increased abdominal fat to age and get sick faster. We can provide precision medicine for patients with cardiovascular diseases like angina, diabetes, high cholesterol, and hypertension now.