Stable CAD: Companion Cases

54M with confirmed moderate LAD and CX disease and CCS class 2 symptoms. He is a nonsmoker. Diabetes with recent A1C of 8%. No hypertension. EF 50%. LDL 1.8. Medications: ASA 81mg OD, Metformin 1000mg BID, Crestor 20mg OD. BP 130/80 HR 85. What will you prescribe?

He comes back to clinic on same meds but also Bisoprolol 5mg OD. His symptoms are under control. He has since been diagnosed with hypertension. He asks you if he can reduce his CV mortality by intensive blood pressure control. What should his systolic target be?

A. 160

B. 140

C. 120

D. No systolic target

Case 1C: Now has worsening angina. BP 105/70 HR 80 (regular). Meds: ASA 81mg OD, Metformin 1000mg BID, Empagliflozin 25mg OD, Crestor 20mg OD, Perindopril 4, Bisoprolol 10mg OD, Amlodipine 10mg OD. What changes would you make?

Admitted with NSTEMI. BP 130/80 HR 60 (regular). Meds: ASA 81mg OD, Metformin 1000mg BID, Empagliflozin 25mg OD, Crestor 20mg OD, Perindopril 4, Bisoprolol 10mg OD, Ivabradine 5mg BID. What changes would you make?
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