Individualized antianginal therapy guided by systemic arterial pressure.

All antianginal drugs except nitrates are also first-line antihypertensive drugs. Their antianginal efficacy has not been evaluated in relation to pretreatment blood pressure. They may aggravate ischemia due to excessive reduction in blood pressure. Until the results of direct comparative studies are available, it is advisable to start treatment of angina pectoris in normotensive and hypotensive patients with other drugs that do not primarily decrease blood pressure. Nitrates are a reasonable choice.