New Guidelines for Myocardial Ischemia Management

β-blocker (prior MI), ACEI/ARB (diabetes and/or LV dysfunction), and diuretic If β-blocker contraindicated or side effects occur, substitute a nonDHP CCB Add long-acting DHP CCB to β-blocker, ACEI/ARB, diuretic regimen if angina or BP remains uncontrolled Target BP is <130/80 mm Hg or <120/80 mm Hg if LV dysfunction is present AHA Scientific Statement: Pharmacologic treatment of hypertension in stable anginaIIIaIIbIII A B B B Rosendorff C et al. Circulation. 2007;115:

BP <120/80 mm Hg LDL-C <100 mg/dL Antiplatelet therapy β-Blocker ACEI or ARB A1C <7% Aldosterone blocker (select women) CVD prevention in high-risk women: Class I recommendations Smoking cessation Heart-healthy eating pattern Regular physical activity Weight management Mosca L et al. Circulation. 2007;115:

CVD prevention in high-risk women: Class II recommendations Consider LDL-C <70 mg/dL (very-high-risk women) HDL/non-HDL therapy Omega-3 fatty acid supplementation Depression referral and treatment Mosca L et al. Circulation. 2007;115:

Optimal patient care in stable CAD: Summary Establish aggressive treatment goals Utilize intensive, multifaceted therapy to achieve and maintain treatment goals –Lifestyle modification –Risk factor reduction –Antianginal therapy