What is the target for BP reduction based on patient characteristics and comorbidities?
The target for BP reduction may differ based on patient characteristics and comorbidities. For example, in genetic studies ancillary to the Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial (ALLHAT), individuals with the stromelysin (matrix metalloproteinase-3) genotype 6A/6A had higher stroke rates on lisinopril than on chlorthalidone, and those with the 5A/6A genotype had lower stroke rates on lisinopril. Carriers of mutations of the fibrinogen-gene also had a lower risk of stroke on lisinopril compared with amlodipine than those who were homozygous for the usual allele. However, the role of genetic testing in hypertension management remains undefined at present.