Abstract

The main goal of treating hypertension is to reduce blood pressure to physiological levels and thereby prevent risk of cardiovascular disease and hypertension-associated target organ damage. Despite reductions in major risk factors and the availability of a plethora of effective antihypertensive drugs, the control of blood pressure to target values is still poor due to multiple factors including apparent drug resistance and lack of adherence. An explanation for this problem is related to the current reductionist and ‘trial-and-error’ approach in the management of hypertension, as we may oversimplify the complex nature of the disease and not pay enough attention to the heterogeneity of the pathophysiology and clinical presentation of the disorder. Taking into account specific risk factors, genetic phenotype, pharmacokinetic characteristics, and other particular features unique to each patient, would allow a personalized approach to managing the disease. Personalized medicine therefore represents the tailoring of medical approach and treatment to the individual characteristics of each patient and is expected to become the paradigm of future healthcare. The advancement of systems biology research and the rapid development of high-throughput technologies, as well as the characterization of different –omics, have contributed to a shift in modern biological and medical research from traditional hypothesis-driven designs toward data-driven studies and have facilitated the evolution of personalized or precision medicine for chronic diseases such as hypertension.

Highlights

  • Hypertension occurs in more than one billion individuals, and its prevalence appears to affect approximately 40% of the general population, with an increase upon aging from 7% in younger individuals (18–39 years old), to 65% in individuals over 59 years old [1]

  • Prospective cohort studies have reported a continuous log-linear association between blood pressure and vascular events beginning at values of 115/75 mmHg with no apparent threshold [4,5,6,7,8,9]

  • Hypertension contributes to an unequaled burden of disease globally [13], for example, Western European countries exhibit a downward trend, in contrast with Eastern European countries, which show an increase in death rates from stroke [14,15]

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Summary

Review Article

Personalized medicine—a modern approach for the diagnosis and management of hypertension. Despite reductions in major risk factors and the availability of a plethora of effective antihypertensive drugs, the control of blood pressure to target values is still poor due to multiple factors including apparent drug resistance and lack of adherence. An explanation for this problem is related to the current reductionist and ‘trial-and-error’ approach in the management of hypertension, as we may oversimplify the complex nature of the disease and not pay enough attention to the heterogeneity of the pathophysiology and clinical presentation of the disorder. The advancement of systems biology research and the rapid development of high-throughput technologies, as well as the characterization of different –omics, have contributed to a shift in modern biological and medical research from traditional hypothesis-driven designs toward data-driven studies and have facilitated the evolution of personalized or precision medicine for chronic diseases such as hypertension

Introduction
Stratifying patients based on renin profiling
Findings
Genomics and pharmacogenomics

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