The number of persons with coronary artery disease (CAD) is increasing
dramatically, with more patients surviving myocardial infarction (MI), the
aging of the population, and the increasing prevalence of diabetes, obesity,
and inactivity.1 As a result, deaths from cardiovascular
disease have increased about 2.5% per year over the past decade.2 Yet
there is a paucity of prospective randomized trial data on the relative impact
of various drugs and blood pressure levels on adverse outcomes in patients
with CAD. This information is critical to current management of these patients
for many reasons. Past experiences have demonstrated that patients with myocardial
ischemia may react differently to many drugs that otherwise appear safe (eg,
nifedipine, phosphodiesterase inhibitors, antiarrhythmic agents, rofecoxib)
and reducing blood pressure in patients with CAD is very complex. To this
end, 2 large randomized clinical trials3,4 examining
blood pressure treatment in patients with CAD provide important new information
on this issue.
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