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March 10, 2003

High Blood Pressure in African Americans

Arch Intern Med. 2003;163(5):521-522. doi:10.1001/archinte.163.5.521

TREATMENT OF elevated blood pressure has been shown to reduce the risk of death and disability for groups of patients with hypertension. However, because we have not yet learned how to focus our prevention and treatment efforts on the individual patients most likely to experience the negative health consequences, we treat millions of people at relatively low risk of serious consequences so as not to miss treating those at high risk.

Elaboration of the human genome has resulted in the discovery of many polymorphisms of specific human genes related to the pathophysiology of hypertension and holds the promise of a method to identify those people most at risk. Unfortunately, the important discoveries made to date apply only to a very small number of people. Combinations of gene polymorphisms such as reported by Staessen et al1 show potential, but this work is extraordinarily time-consuming, and the findings may not apply to people outside of the specific population studied. The new science of pharmacogenomics will likely help us to be more specific in our drug therapy for patients with hypertension, but it does not yet provide the ability to focus on individual patient risks.2

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