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November 10, 2004

What Is the Optimal Blood Pressure and Drug Therapy for Patients With Coronary Artery Disease?

Author Affiliations

Author Affiliation: Division of Cardiovascular Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville.

JAMA. 2004;292(18):2271-2273. doi:10.1001/jama.292.18.2271

The number of persons with coronary artery disease (CAD) is increasing dramatically, with more patients surviving myocardial infarction (MI), the aging of the population, and the increasing prevalence of diabetes, obesity, and inactivity.1 As a result, deaths from cardiovascular disease have increased about 2.5% per year over the past decade.2 Yet there is a paucity of prospective randomized trial data on the relative impact of various drugs and blood pressure levels on adverse outcomes in patients with CAD. This information is critical to current management of these patients for many reasons. Past experiences have demonstrated that patients with myocardial ischemia may react differently to many drugs that otherwise appear safe (eg, nifedipine, phosphodiesterase inhibitors, antiarrhythmic agents, rofecoxib) and reducing blood pressure in patients with CAD is very complex. To this end, 2 large randomized clinical trials3,4 examining blood pressure treatment in patients with CAD provide important new information on this issue.