Recently, there has been considerable controversy concern- ing the appropriateness of using -blockers as first-line therapy in hypertension in those patients who do not have a compel- ling indication; however, their use in patients with angina, prior MI, or HF has a solid basis of positive data. -Blockers should be prescribed as initial therapy for the relief of symptoms in patients with stable angina. -Blockers may be considered as long-term therapy for all other patients with coronary or other vascular disease. Recent ACC Foundation/AHA guide- have recommended -blocker therapy in patients with normal LV function after MI or ACS (Class I; Level of Evidence B), specifically carvedilol, metoprolol succinate, or bisoprolol, in all patients with LV systolic dysfunction (ejec- tion fraction 40%) or with HF or prior MI unless contrain- dicated (Class I; Level of Evidence A). -Blockers should be started and continued for 3 years in all patients with normal LV function after MI or ACS (Class I; Level of Evidence B).168 170 4.1.2. Calcium Channel Blockers As a class, CCBs reduce myocardial oxygen demand by decreasing peripheral vascular resistance and lowering BP and increase myocardial oxygen supply by coronary vasodilation. The nondihydropyridine agents diltiazem and verapamil also decrease the sinus node discharge rate and slow atrioventricu- lar nodal conduction. 