The clinical approach to hypertension requires evolution. Previously, cardiovascular medicine has relied heavily on broad demographics to enable treatment. Today, modern epidemiology proves that an individual’s environment, and socioeconomic factors influence health outcomes. While current European guidelines try to bridge the gap by combination therapies. To achieve the best cardiovascular outcomes across a variety of groups, race-based prescribing must give way to personalized precision medicine that uses pharmacogenomics and direct biomarker profiling in the management of hypertension.