32
Hypertension in Patients With Comorbidities
Stable Ischemic Heart Disease
COR LOE
Recommendations
I SBP:
B-R
In adults with SIHD and hypertension, a BP target of less than
130/80 mm Hg is recommended.
DBP:
C-EO
I SBP:
B-R
Adults with SIHD and hypertension (BP ≥130/80 mm Hg )
should be treated with medications (e.g., guideline-directed
management and therapy (GDMT) beta blockers, ACE
inhibitors, or ARBs) for compelling indications (e.g., previous
MI, stable angina) as first-line therapy, with the addition of other
drugs (e.g., dihydropyridine CCBs, thiazide diuretics, and/or
mineralocorticoid receptor antagonists) as needed to further
control hypertension.
DBP:
C-EO
I B-NR In adults with SIHD with angina and persistent uncontrolled
hypertension, the addition of dihydropyridine CCBs to GDMT
beta blockers is recommended.
IIa B-NR In adults who have had a MI or acute coronary syndrome, it is
reasonable to continue GDMT beta blockers beyond 3 years as
long-term therapy for hypertension.
IIb C-EO Beta blockers and/or CCBs might be considered to control
hypertension in patients with coronary artery disease (without
HFrEF) who had an MI more than 3 years ago and have angina.
