Conversation with Dr. Sakima Smith, Ohio State University Wexner Medical Center

Developing Personalized Cardiovascular Care

NIMHD’s Conversations with Researchers Advancing Health Equity

February is African American History Month. As we celebrate the significant contributions to America—from its history through present day—by people who represent Black and African American communities, we recognize researchers who are promoting health equity through their work to advance the science of minority health and health disparities.

Dr. Sakima Smith

Meet Sakima Smith, M.D., M.P.H., principal investigator in minority health and health disparities research.

Go to the Q&A with Dr. Smith

Dr. Sakima Smith is an associate professor of medicine, Division of Cardiology, Section of Heart Failure and Cardiac Transplantation in the Department of Internal Medicine at the Ohio State University Wexner Medical Center.

Dr. Smith obtained his medical degree from Temple University School of Medicine in 2006. He completed his internal medicine residency at Barnes-Jewish Hospital/Washington University in 2009 and completed his general cardiology and heart failure cardiology fellowships at Ohio State. He also completed a research fellowship and a master’s degree in public health from Ohio State in 2014. He was awarded the James V. Warren Fellowship Research Award in 2014; in 2017 he received the Denman Distinguished Undergraduate Research Mentor award; and in 2019 he was the Landacre Research Honor Society Distinguished Researcher of the Year.

Dr. Smith has established his independent research lab through funding from the Robert Wood Johnson Faculty Development Grant in 2015, an NHLBI K08 career development grant in heart failure and arrhythmia clinical research in 2017, and an NIMHD grant, “Translational Candidate-Gene Studies of Simvastatin-Induced Myopathy in African Americans” (R01 MD011307), in 2018. His research program spans basic cardiovascular research to population health, diversity, and health outcomes. He is currently the associate program director for the cardiovascular medicine fellowship program, Vice Chair for Diversity, Equity and Inclusion in the Department of Internal Medicine, and the Chief Diversity Officer for the Heart and Vascular Institute.

Q & A with Dr. Sakima Smith

What is your research goal, purpose and aim?
I study mechanisms involved in cardiovascular disease—specifically pathways at the cellular and molecular level—to uncover new signals within those pathways, which creates more targeted and streamlined treatment approaches. This research provides insight into what drugs are the most effective in treating cardiovascular disease in different patient populations. This discovery also allows us to look at repurposing existing drugs in different ways, instead of taking 20 years and billions of dollars to develop an entirely new drug. Our clinical studies are designed to compare clinical scenarios and translate the findings to patient care.

We have grants through the NIH to study adverse cardiovascular events based on different genes with respect to metabolism of different statins. We are looking at certain gene variants that make African Americans more prone to the adverse effects of statins, which work to lower cholesterol and risk of heart disease and stroke.

How is your work advancing the science and health of populations experiencing health disparities? Are you seeing specific changes in particular communities or groups?
We are studying how certain drugs are metabolized in African Americans and other population groups, to better understand these groups’ vulnerability to adverse effects or reduced efficacy of these drugs.

We intentionally recruit African American patients, identify those with certain variants of interest, and have them complete a pharmacokinetic study to test the outcome (metabolism) of the statin over 24 hours. Through our ongoing studies, we have identified which variants are common among African American patients and discovered additional novel variants and pathways to investigate further.

Our clinical work has provided new insight into how African American patients respond to statins, which could explain the disproportionate effect of cardiovascular disease on African Americans. Uncovering these connections would support the personalization of drug treatment on a population level which could reduce morbidity and mortality.

From the research you are doing, what has surprised you about the discoveries from your lab and its impact?
I am still at an early stage in my clinical research, but one interesting surprise was that the variant that we initially pursued based on our data, didn’t pan out when we completed our proof-of-concept study. This gave us a new hypothesis to test and allowed for new discovery, which could prove to be even more promising. In due time, we will be able to share our findings with other larger studies.

What inspired you to become a researcher in minority health and health disparities?
I have always asked “why” questions, wanting to better understand disease processes, mechanisms, and pathways, which made me a natural researcher. Through excellent mentors at Ohio State, I was exposed to translational research very early in my career. This collegiate atmosphere, mentorship and support led me to a scientific career as a faculty member and a translational physician scientist with an independent lab.

I have been deliberate in the integration of my research, clinical efforts and administration roles to address health disparities and minority health. Asking why cardiovascular disease disproportionately affects African Americans has launched my research path, a path that has been supported by Ohio State, which believes biological, genetic and cultural diversity strengthens our mission to provide evidence-based health care. This translates to a greater understanding and appreciation for each patient’s unique genetic makeup, behavior, experiences, and beliefs.

How do we encourage the next generation of scientists?
We must remind the next generation of scientists to continue to work to understand basic and translational science so they can continue to ask fundamental scientific questions that will impact patients. Then we need to figure out how to translate our amazing discoveries from the bench to the bedside in a safe and efficient way so we can directly improve health and improve lives.

We need to help learners consider the rewards and challenges of being a physician scientist and facilitate the collaboration between researchers and physicians.

We also need to make sure the next generation have examples of those who made great scientific discovery while seeing patients, and how the collision of these two worlds really drives innovation.

What do you envision as the future of minority health and health disparities research?
Determining how a certain patient population might respond to treatment based on genetics and molecular differences will put us on the path of developing more personalized care. This will ensure we match the right drugs and the right treatments to patients according to their particular characteristics. This will allow more targeted and deliberate use of pharmaceuticals.

Minority health and health disparities research will help us understand at a cellular level differences in disease processes among different population groups, so we can optimize treatments according to the individual and ensure that conditions like cardiovascular disease no longer disproportionately affect African Americans. We will have discovered novel drug pathways and altered existing treatments through a deliberate mechanistic approach. We will be closer to balancing care delivery, barriers of care, and differences in outcomes amongst the most vulnerable, specifically racial, and ethnic minorities and those of low socioeconomic status.

Page updated January 28, 2022