title: [Treatment of hypertension in patients with coronary arterial disease].
abstract: Reports of randomized controlled trials and prospective observational studies provide the most reliable data on the association between blood pressure and coronary heart disease (CHD). The totality of the evidence indicate a strong association between blood pressure and coronary heart disease, which is continuous at levels of less than 115 mm Hg of systolic. In general, 60 to 69 years of age, 10 lower mm Hg systolic blood pressure is associated with lower risk of one-fifth of a coronary heart disease event. The size and shape of this Association are consistent in all regions, for men and women and life-threatening events such as stroke and myocardial infarction. Trials that compared active treatment with placebo or no treatment have shown that the benefits of reducing blood pressure with different classes of drugs (e.g., diuretics, beta-blockers, ACE inhibitors, calcium antagonists) are quite similar, with about a fifth of reduction in coronary heart disease. The important points in this review are: First, that the relative benefit to the decline in blood pressure for the prevention of coronary heart disease appears to be constant in a range of different populations. Second, it is likely that considerable benefit with blood pressure low below thresholds of "traditional" blood pressure (140/90 mm Hg), especially in those with high absolute risk. Third, start, reduce with caution -especially in adult- and keep the maximum tolerance of blood pressure reduction is an issue more important than the choice of the initial agent.
authors.affiliation: División de Investigación en Salud, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. mrosas_peralta@hotmail.com.
authors.forename: Martín
authors.initials: M
authors.lastname: Rosas-Peralta
authors.forename: Gabriela
authors.initials: G
authors.lastname: Borrayo-Sánchez
authors.forename: Alejandra
authors.initials: A
authors.lastname: Madrid-Miller
authors.forename: Erick
authors.initials: E
authors.lastname: Ramírez-Arias
authors.forename: Gilberto
authors.initials: G
authors.lastname: Pérez-Rodríguez
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension; Myocardial ischemia; Prevention