Area of concern	Blood pressure target (mm Hg)	Lifestyle modification*	Drug indications	Comments
General CAD prevention	< 140/90	Yes	Any effective antihypertensive drug or combination†	If systolic blood pressure is ≥ 160 mm Hg or diastolic blood pressure is ≥ 100 mm Hg, start therapy with two drugs
High CAD risk‡	< 130/80	Yes	ACE inhibitor or ARB or CCB or thiazide diuretic or combination	If systolic blood pressure is ≥ 160 mm Hg or diastolic blood pressure is ≥ 100 mm Hg, start therapy with two drugs
Stable angina	<130/80	Yes	Beta blocker and ACE inhibitor or ARB	If beta blockers are contraindicated or if adverse effects occur, diltiazem (Cardizem) or verapamil (Calan) can be substituted (but not if bradycardia or LV dysfunction is present)
				A dihydropyridine CCB (not diltiazem or verapamil) can be added to beta blocker
				A thiazide diuretic can be added for blood pressure control
Unstable angina or non–ST-elevation MI	< 130/80	Yes	Beta blocker (if patient is hemodynamically stable) and ACE inhibitor or ARB§	If beta blockers are contraindicated or if adverse effects occur, diltiazem or verapamil can be substituted (but not if bradycardia or LV dysfunction is present)
				A dihydropyridine CCB (not diltiazem or verapamil) can be added to beta blocker
				A thiazide diuretic can be added for blood pressure control
ST-elevation MI	< 130/80	Yes	Beta blocker (if patient is hemodynamically stable) and ACE inhibitor or ARB§	If beta blockers are contraindicated or if adverse effects occur, diltiazem or verapamil can be substituted (but not if bradycardia or LV dysfunction is present)
				A dihydropyridine CCB (not diltiazem or verapamil) can be added to beta blocker
				A thiazide diuretic can be added for blood pressure control
LV dysfunction	< 120/80	Yes	ACE inhibitor or ARB and beta blocker and aldosterone antagonist∥and thiazide or loop diuretic and hydralazine/isosorbide dinitrate (Bidil; in self-identified black patients)	The following drugs are contraindicated: verapamil, diltiazem, clonidine (Catapres), moxonidine (not available in the United States), alpha adrenergic blockers