Journal of the American Society of Hypertension
-(-)
(2015) 1–3
Commentary
New guidelines for hypertension control in cardiac patients – lower may not be better Aram V. Chobanian, MD* Department of Medicine, Boston University School of Medicine, Boston, MA, USA Manuscript received February 9, 2015 and accepted March 10, 2015
The current issue of the Journal of the American Society of Hypertension includes a comprehensive Scientific Statement on the treatment of hypertension in patients with coronary artery disease (CAD) that updates an earlier report in 2007 from the American Heart Association (AHA).1,2 Importantly, the current writing committee now also includes representatives from the American College of Cardiology and the American Society of Hypertension, thus combining the efforts of major segments of the cardiovascular community in developing unified recommendations. This Scientific Statement provides a thorough and balanced presentation that addresses many of the unresolved and controversial issues regarding the management of ischemic heart disease (IHD) and its secondary prevention. These include the optimal levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) to be achieved and the selection of antihypertensive drugs for these patients with CAD. The writing committee has considered the bulk of available evidence, rather than focusing primarily on data from controlled clinical trials, to reach its conclusions. This contrasts with the recent management guidelines provided by the JNC–8 writing group, which had a narrow scope, focusing greatly on the results of randomized clinical trials and leaving unaddressed some important clinical questions facing practicing clinicians.3 Each of the new recommendations has been classified appropriately according to its level of evidence and size of treatment effect. General agreement has existed that lowering BP to
-(-)
(2015) 1–3
Commentary
New guidelines for hypertension control in cardiac patients – lower may not be better Aram V. Chobanian, MD* Department of Medicine, Boston University School of Medicine, Boston, MA, USA Manuscript received February 9, 2015 and accepted March 10, 2015
The current issue of the Journal of the American Society of Hypertension includes a comprehensive Scientific Statement on the treatment of hypertension in patients with coronary artery disease (CAD) that updates an earlier report in 2007 from the American Heart Association (AHA).1,2 Importantly, the current writing committee now also includes representatives from the American College of Cardiology and the American Society of Hypertension, thus combining the efforts of major segments of the cardiovascular community in developing unified recommendations. This Scientific Statement provides a thorough and balanced presentation that addresses many of the unresolved and controversial issues regarding the management of ischemic heart disease (IHD) and its secondary prevention. These include the optimal levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) to be achieved and the selection of antihypertensive drugs for these patients with CAD. The writing committee has considered the bulk of available evidence, rather than focusing primarily on data from controlled clinical trials, to reach its conclusions. This contrasts with the recent management guidelines provided by the JNC–8 writing group, which had a narrow scope, focusing greatly on the results of randomized clinical trials and leaving unaddressed some important clinical questions facing practicing clinicians.3 Each of the new recommendations has been classified appropriately according to its level of evidence and size of treatment effect. General agreement has existed that lowering BP to
