Recommendations: Coronary Heart Disease Treatment (1)

Recommendations for the treatment of coronary heart disease1 are summarized on two slides Slide 1 of 2 In patients with known CVD, ACE inhibitor (C), aspirin (A), and statin therapy (A) (if not contraindicated) should be used to reduce the risk of cardiovascular events1 In patients with prior MI, β-blockers should be continued for at least 2 years postevent (B)1 In all patients with diabetes, cardiovascular risk factors should be assessed at least annually These risk factors include dyslipidemia, hypertension, smoking, a positive family history of premature coronary disease, and the presence of micro- or macroalbuminuria Abnormal risk factors should be treated as described elsewhere in these guidelines Patients at increased CHD risk should receive aspirin and a statin, and ACE inhibitor or ARB therapy if hypertensive, unless there are contraindications to a particular drug class Although clear benefit exists for ACE inhibitor and ARB therapy in patients with nephropathy or hypertension, the benefits in patients with CVD in the absence of these conditions is less clear, especially when LDL cholesterol is concomitantly controlled2,385References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S34. Braunwald E, Domanski MJ, Fowler SE, et al for the PEACE Trial Investigators. Angiotensin-converting-enzyme inhibition in stable coronary artery disease. N Engl J Med 2004;351:2058-2068. Yusuf S, Teo K, Anderson C, et al for the Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008;372:1174-1183.