Rational Medical Therapy Is the Key to Effective Cardiovascular Disease Prevention

There have been, and will be more, calls for personalized medicine on the basis of genotyping. This narrative review, originally written as one side of a debate, is on the basis of learnings from > 40,000 patients in 40 years of a career focused on stroke prevention, and is intended to be provocative. I will argue from the perspective of a clinical pharmacologist that rational use of already existing medical therapy, on the basis of knowledge of clinical pharmacology and on phenotyping our patients, could have a greater effect, and could be implemented immediately, while awaiting the development of cost-effective chips to guide therapy

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