The new update from AHA/ACC/ASH clarifies the treatment targets in those with CAD as well as CAD with other cardiovascular conditions

Physicians should aim to treat blood pressure to a target of less than 140/90 mm Hg for the majority of patients with coronary artery disease (CAD) and hypertension, according to a new update to the US guidelines for managing hypertension[1].

In some patients with CAD, however, particularly those who have had prior MI, stroke, transient ischemic attack (TIA), or other conditions such as peripheral artery disease or an abdominal aortic aneurysm, a target blood-pressure goal of 130/80 mm Hg is also reasonable, according to the experts.

The statement—issued jointly by the American Heart Association (AHA), American College of Cardiology (ACC), and the American Society of Hypertension (ASH)—reinforces beta-blockers as the cornerstone of treatment in CAD patients with hypertension along with an ACE inhibitor or angiotensin-receptor blocker (ARB) and a thiazide or thiazidelike diuretic.

The new scientific statement, from writing committee chair Dr Clive Rosendorff (Veterans Affairs Medical Center, New York) and published March 31, 2015 in Circulation, the Journal of the American College of Cardiology, and the Journal of the American Society Hypertension, is intended to bring some clarity to the hypertension community since the release of the Eighth Joint National Committee (JNC 8) guidelines for the treatment of high blood pressure.

As reported by heartwire , the JNC 8 writing group relaxed the more aggressive JNC 7 target blood pressures and treatment-initiation thresholds in elderly patients and in patients under age 60 with diabetes and kidney disease. For patients 60 years of age, but without a history of cardiovascular disease, the JNC 8 treatment target is less than 150/90 mm Hg. As noted at the time, the decision to "ease up" in these older patients was questioned by some hypertension experts.

The new update from AHA/ACC/ASH clarifies the treatment targets in those with CAD as well as CAD with other cardiovascular conditions.

Source: www.medscape.com