LAUSR

See related article, pp 412–419 The history of hypertension research is sweet sour. Huge advances have been marred by the persistence of huge black boxes. The term primary hypertension epitomizes the issue: the underlying causes and pathophysiology of most cases of hypertension remain undefined. Furthermore, guideline panels are unable to agree on desirable target blood pressure values, and it may be the time to think about the cure of hypertension rather than just the control of blood pressure. The quote attributed to Einstein, “Insanity: doing the same thing over and over again and expecting different results” may provide some clues. It is likely that the next large conceptual leaps in our understanding of hypertension are based on the application of a novel technology not previously used for this purpose. In this regard, scientific advances depend to a large extent on technological advances that make them possible.1 Hypothesis-based approaches must rely on current knowledge, and we are aware that this is limited. Systems biology provides a nonbiased approach that recognizes the current limitations of our understanding of hypertension. Gajjala et al2 have used plasma proteomics to identify in a nonbiased manner potential molecular determinants that allowed the development of a model capable to discriminate between hypertensive and normotensive individuals. There are 2 main potential clinical consequences of these studies: the use of the proteomics panel as a biomarker and the identification of putative contributors to the pathophysiology of hypertension. As a biomarker of hypertension, the panel cannot, by definition, outperform a cheap and easy to use, noninvasive approach: measurement of blood pressure. So further studies are needed to explore whether the proteomics model may predict outcomes, …