Diagnosis
Figure 4. Guideline-Directed Medical Therapy for Patients
with SIHD
8
Consider
adding bile-
sequestrant or
niacin
ASA
75-162 mg
daily
Lifestyle
modification
including diet,
weight loss, physical
activity
Clopidogrel
75 mg
daily or ASA
desensitization
Serious adverse
effect or
contraindiction
See AHA/ACCF
Cardiovascular
Risk Reduction
Guideline
Smoking
cessation
program
YES
Moderate-
to high-dose
statin
Contraindicated
or adverse effect
See NHLBI ATP
III Prevention
Guideline
YES
See JNC VII
Guidelines
Drug therapy to
achieve BP
<140/90 mm Hg
Consider ACEI/ARB if LV
dysfunction, diabetes,
CKD
YES
Appropriate
glycemic control
YES
Note: Colors correspond to the class of recommendations in the ACCF/AHA
Cigarette
Smoking ?
Hypertension?
BP ≥140/90 mm Hg
aer diet, physical
activity program?
Diabetes?
