Antihypertensive therapy to maximally reduce coronary risk

Antihypertensive therapy as it is currently prescribed has not provided the degree of protection against coronary disease that was predicted by epidemiologic evidence. At least five steps can be taken to maximally reduce coronary risk: (1) more frequent, out-of-the-office monitoring of blood pressure, particularly during the early morning hours; (2) diligent search for other coexisting coronary risk factors; (3) vigorous use of various life-style modifications; (4) greater selectivity in the choice of antihypertensive agents, using those that may provide additional benefits for other coronary risk factors and other coexisting conditions; and (5) avoidance of coronary hypoperfusion by too great a reduction of blood pressure.