Age and blood pressure goal in women with prior coronary events

The three more important sequalae of sustained hypertension in the heart, include heart failure (HF), conduction to arrhythmia particularly atrial fibrillation (AF) and coronary artery disease (CAD). In this issue of the journal Sava et al. [1] describe analyzing the data from the INternational VErapamil SR-Trandolapril (INVEST) study [2] the optimal systolic blood pressure (BP) to reduce mortality in women with previous coronary events. In a very recent review by Mehilli and Presbitero [3] the characteristics of women with CAD and acute coronary syndrome (ACS) are amply described. Women with CAD differ from men by several aspects as the clinical presentation, the accompanying comorbidities and risk factors, as well as, by the delivery of medical care. Moreover, women use to be older and present frequent and pronounced frailty. They present more frequently ACS without obstructive coronary arteries which makes it difficult the diagnosis and treatment of ACS. Importantly, in young women compared to men early death is more frequent in women, as well as, in older women during the first year after an ACS. The two main Guidelines for the management of arterial hypertension that of European Society of Cardiology (ESC)/European Society of Hypertension (ESH) [4] and that of the American College of Cardiology (ACC)/American Heart Association (AHA) [5] differ in the recommended BP goal for patients with chronic CAD depending on their age. The European Guideline defines the systolic goal BP in patients with CAD as inferior to 130/80 mmHg when the age of the patient is