Optimal medical treatment of hypertension in patients with coronary artery disease.

Optimal medical treatment of hypertension in patients with coronary artery disease. Expert Rev Cardiovasc Ther. 2018 Oct 08;: Authors: Mahtta D, Elgendy IY, Pepine CJ Abstract INTRODUCTION: Coronary artery disease (CAD) remains the leading cause of mortality and morbidity worldwide, and hypertension is its most prevalent modifiable risk factor. Patients with CAD and concomitant hypertension are a special population with distinct physiologic and structural alterations. Optimal blood pressure (BP) control in this population has been linked with reduction in adverse outcomes, however, excessive lowering of BP could jeopardize myocardial and cerebral perfusion. Areas covered: Authors highlight the prevalence of the CAD and hypertension dyad, as well as the implications of various structural and physiological changes in this population. Subsequently, available data on optimal BP targets in such patients, and lastly provide more insight into the J-curve phenomenon as well as antihypertensive agent use is discussed. Expert commentary: Current guideline recommendations are based on data from trials such as SPRINT which did not specifically focus on the CAD population. Based on data from observational studies and post hoc analyses, the best therapeutic systolic (SBP) and diastolic (DBP) targets may be ~130 mmHg and ~80 mmHg, respectively. Caution should be taken to not lower SBP below 120 mmHg and DBP below 60 mmHg. PMID: 30295548 [Pu...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research