Are All the Hypertensives Made Equal?

William Wagner · medicine forum Guru Joined: 29 Apr 2005 Posts: 809

1: Herz. 2006 Jun;31(4):323-330.
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Are All the Hypertensives Made Equal?

Flaa A, Kjeldsen SE.

Department of Cardiology, Ullevaal University Hospital, Oslo, Norway.

Blood pressure lowering in hypertensive patients is of significant
importance. The complex pathophysiology makes the therapeutic targets
many, and extensive research has provided us with many antihypertensive
drugs. However, data indicate that the proportion of patients with
controlled blood pressure is far from satisfying. This may partly be
explained by a lack of individualized treatment. Present guidelines for
management of hypertension emphasize that a thorough evaluation of the
patient is necessary before initiating treatment. Based on information
about gender, age, ethnicity, family history, clinical examination and
concomitant diseases like diabetes mellitus, coronary heart disease,
heart failure, cerebrovascular disease and gout, the physician is able
to provide the best treatment. However, most patients need two to three
drugs to control the blood pressure. Thus, we need methods to predict
blood pressure responses to the various drugs in the individual
patients. Possibly, in the future treatments may be based upon genetic
variants. Until now, several polymorphisms in genes regulating blood
pressure have been located, and these may influence responses to drugs.
However, the results are heterogeneous and contradictory, and we are yet
not capable of determining the best treatment based on genetic
properties. Coming years challenge us to further clarify these
potentially important aspects of treatment. Meanwhile, physicians are
obligated to individualize the treatment by other means, based on
disease history, concomitant diseases and clinical examination.

PMID: 16810472 [PubMed - as supplied by publisher]

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