Abstract
The Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension (JNC VI) recommends that diuretics or β blockers be used as initial drugs in the treatment of older persons with systemic hypertension because these drugs have been demonstrated to reduce cardiovascular morbidity and mortality in controlled clinical trials.1 Persons with prior myocardial infarction should be treated with β blockers without intrinsic sympathomimetic activity1–5 and angiotensin-converting enzyme (ACE) inhibitors1,5,6 and not with calcium channel blockers5,7,8 or α blockers.9 We report data from an observational study of 1,212 patients with prior myocardial infarction and systemic hypertension treated with different antihypertensive drugs and followed prospectively for the incidence of new coronary events.
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