Coronary heart disease secondary prevention blood pressure control

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Blood Pressure Control

• If blood pressure is > 120/80 mm Hg:

Initiate or maintain lifestyle modification (weight control, EtOH moderation, sodium reduction, increased physical activity, increased fruits, vegetables, low-fat dairy)

• If blood pressure > 140/90 mm Hg: As tolerated, add blood pressure medication (betablockers and/or ACE inhibitors initially).

AHA/ACC Secondary Prevention for Patients With Coronary and Other Vascular Disease : 2006 Update (DO NOT EDIT)

Goal: <140/90 mm Hg or <130/80 mm Hg if patient has diabetes or chronic kidney disease.

For all Patients:

Class I

"1. Initiate or maintain 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. (Level of Evidence: B) "

For patients with blood pressure ≥140/90 mm Hg (or ≥130/80 mm Hg for individuals with chronic kidney disease or diabetes):

Class I

"1. As tolerated, add blood pressure medication, treating initially with β-blockers and/or ACE inhibitors, with addition of other drugs such as thiazides as needed to achieve goal blood pressure. (Level of Evidence: A)"

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