Coronary heart disease secondary prevention blood pressure control
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
If a patient's blood pressure is greater than 120/80 mm Hg, lifestyle modifications such as weight control, alcohol moderation, salt reduction, increased physical activity, more fruits, more vegetables, and low-fat dairy diets should be initiated. If a patient's blood pressure is greater than 140/90 mm Hg then blood pressure medications such as beta blockers and ACE inhibitors should be added as tolerated.
2006 AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and other Atherosclerotic Vascular Disease (DO NOT EDIT) [1]
Blood Pressure Management (DO NOT EDIT) [1]
| Class I |
| "1. All patients should be counseled regarding the need for lifestyle modification: weight control; increased physical activity; alcohol moderation; sodium reduction; and emphasis on increased consumption of fresh fruits, vegetables, and low-fat dairy products. [2][3][4][5][6] (Level of Evidence: B) " |
| "2. Patients with blood pressure ≥140/90 mm Hg should be treated, as tolerated, with blood pressure medication, treating initially with β-blockers and/or ACE inhibitors, with addition of other drugs as needed to achieve goal blood pressure. [2][7][8] (Level of Evidence: A)" |
| “ | Goal: <140/90 mm Hg or <130/80 mm Hg if patient has diabetes or chronic kidney disease. | ” |
References
- ↑ 1.0 1.1 AHA. ACC. National Heart, Lung, and Blood Institute. Smith SC, Allen J, Blair SN; et al. (2006). "AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update endorsed by the National Heart, Lung, and Blood Institute". J Am Coll Cardiol. 47 (10): 2130–9. doi:10.1016/j.jacc.2006.04.026. PMID 16697342.
- ↑ 2.0 2.1 Chobanian AV, Bakris GL, Black HR; et al. (2003). "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure". Hypertension. 42 (6): 1206–52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957. Unknown parameter
|month=ignored (help) - ↑ Appel LJ, Moore TJ, Obarzanek E; et al. (1997). "A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group". N. Engl. J. Med. 336 (16): 1117–24. doi:10.1056/NEJM199704173361601. PMID 9099655. Unknown parameter
|month=ignored (help) - ↑ Sacks FM, Svetkey LP, Vollmer WM; et al. (2001). "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group". N. Engl. J. Med. 344 (1): 3–10. doi:10.1056/NEJM200101043440101. PMID 11136953. Unknown parameter
|month=ignored (help) - ↑ Appel LJ, Frohlich ED, Hall JE; et al. (2011). "The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke: a call to action from the American Heart Association". Circulation. 123 (10): 1138–43. doi:10.1161/CIR.0b013e31820d0793. PMID 21233236. Unknown parameter
|month=ignored (help) - ↑ Whelton SP, Chin A, Xin X, He J (2002). "Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials". Ann. Intern. Med. 136 (7): 493–503. PMID 11926784. Unknown parameter
|month=ignored (help) - ↑ "Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group". JAMA. 265 (24): 3255–64. 1991. PMID 2046107. Unknown parameter
|month=ignored (help) - ↑ "Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)". JAMA. 288 (23): 2981–97. 2002. PMID 12479763. Unknown parameter
|month=ignored (help)