Treatment of hypertension in association with heart failure
- For most hypertensive patients with CAD, an ACE in-hibitor or ARB is recommended (Grade A).
- For hypertensive patients with CAD, but without coex-isting systolic heart failure, the combination of an ACE inhibitor and ARB is not recommended (Grade B).
- For high-risk hypertensive patients, when combination therapy is being used, choices should be individualized. The combination of an ACE inhibitor and a dihydropyridine CCB is preferable to an ACE inhibitor and a thiazide/ thiazide-like diuretic in selected patients (Grade A).
- For patients with stable angina pectoris but without pre-vious heart failure, myocardial infarction, or coronary ar-tery bypass surgery, either a b-blocker or CCB can be used as initial therapy (Grade B).
- Short-acting nifedipine should not be used (Grade D).
- When decreasing SBP to target levels in patients withestablished CAD (especially if isolated systolic hyperten-sion is present), be cautious when the DBP is 60 mm Hg because of concerns that myocardial ischemia might be exacerbated, especially in patients with left ventricular hypertrophy (Grade D).