Sato M, Hasebe N, Kikuchi K
First Department of Internal Medicine, Asahikawa Medical College.
Nihon Rinsho. 2001 May;59(5):949-54.
The management of hypertensive patients with coronary artery disease (CAD) should be started with lifestyle modification for reduction of coronary risk factors. As the principle of drug therapy, rapid decrease in blood pressure below the limits of coronary auto-regulation must be avoided. Clinical trials showed J-curved relationship between diastolic pressure and mortality was not found above 75 mmHg. The current desired goal of blood pressure in patients with CAD might be suggested as 125-140/85-75 mmHg. Pulse pressure should be recognized as a strong predictor for CAD as well as systolic and diastolic blood pressure, especially in elderly patients. The choice of drug therapy have to be based on efficiency in clinical trials, side effects, and also particular condition of each patient.
对于患有冠状动脉疾病（CAD）的高血压患者，管理应从改善生活方式以降低冠状动脉危险因素开始。作为药物治疗的原则，必须避免血压快速降至冠状动脉自动调节范围以下。临床试验表明，舒张压与死亡率之间未发现J形曲线关系高于75 mmHg。目前，CAD患者的血压目标可能建议为125 - 140/85 - 75 mmHg。脉压应被视为CAD以及收缩压和舒张压的有力预测指标，尤其是在老年患者中。药物治疗的选择必须基于临床试验中的疗效、副作用以及每个患者的特殊情况。
