THURSDAY, June 21 (HealthDay News) -- The American Heart Association has issued new guidelines for the treatment of hypertension to prevent coronary artery disease based on the best available data for diastolic and systolic targets, comorbidities and antihypertensive drugs. The guidelines are published in the May 29 issue of Circulation: Journal of the American Heart Association.
Clive Rosendorff, M.D., Ph.D., chair of the American Heart Association in Dallas, Texas, and colleagues note that aggressive blood pressure lowering is appropriate for the primary prevention of heart disease in patients with diabetes, chronic renal disease or other heart disease risk factors, with a target of less than 130/80 mm Hg.
However, in patients with elevated diastolic blood pressure, heart disease and signs of myocardial ischemia, more caution is needed and pressure should be lowered slowly, according to the guidelines. The choice of drugs is controversial, but most patients will need two medications to achieve their target. If pressure is greater than 20/10 mm Hg above goal at the outset, patients can be started on two drugs.
"Studies have shown equivalence of benefit of angiotensin converting enzyme inhibitors and the angiotensin II receptor blockers candesartan or valsartan in heart failure. Either class of agents is effective in lowering blood pressure," the authors write.
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