Terry, a 42-year-old black man who just moved into the area, comes into the clinic for a new client visit. he brings his medical records from his previous health care provider; the records show a blood pressure of 140/104 mm hg on 2 separate occasions. recent laboratory tests (complete blood count, chemistry profile, urinalysis, and thyroid-stimulating hormone) are normal. a recent electrocardiogram shows normal sinus rhythm with left ventricular hypertrophy. he denies any medical problems and tells you he has never been diagnosed with hypertension. he is not taking any medications, does not smoke, and drinks about 2 beers a day. he is currently unemployed. his blood pressure today is 150/110 mm hg. your next step would be to

"1. it should be, it has been for about 20 years, and it's really not much different in the end than breeding animals to have particular traits. there are always concerns about genetically engineered animals/plants affecting the environment in unexpected negative ways, but i can't think of an example where the fears didn't turn out to be baseless.  

first, as you point out, it would be a great advance in pharmacology, to be able to tailor drugs and their doses to me. the pros involve better medical treatment. the cons involve privacy issues like insurance companies denying coverage to people with genetic risk factors. looking at dna markers wouldn't affect the frequency of genetic diseases, but it would allow detection of them earlier. and ok, actually i suppose that if people used this information to avoid having children with genetic diseases, some might decrease in frequency."