In a related vein, in AASK (African-American Study of Kidney Diseases and Hypertension),556 1094 black patients with hypertensive kidney disease (diastolic pressure .95 mm Hg and glomerular filtration rate of 20 to 60 mL/min) and no diabetes mellitus were randomly assigned to achieve a mean arterial pressure target #92 mm Hg (corresponding to 130/ 80 mm Hg) or to a target of 102 to 107 mm Hg (correspond- ing to 140/90 mm Hg). Overall, there was no advantage to more intensive BP control with regard to progression to end-stage kidney disease or death.556 Although in patients with uncomplicated hypertension there are a variety of considerations in selecting a medication, effective BP lowering is the most important factor in prevent- ing stroke and MI. Clinical trials have failed to convincingly demonstrate superiority of any single antihypertensive drug class in preventing cardiovascular events.544,545 In many patients with SIHD, the choice of medications is guided by compelling indications for specific classes of drugs, as discussed elsewhere in this guideline (Table 15).557 ACE inhibitors improve outcomes in most patients with CAD, especially those with a history of MI, LV dysfunction and heart failure, or CKD or diabetes mellitus.295,296,301,558 562 Angiotensin-receptor blockers (ARBs) are beneficial in the same spectrum of patients.563 566 Beta blockers are recom- mended in patients with angina pectoris, a history of MI, or LV dysfunction.567 571 Aldosterone antagonists improve prognosis in patients with LV dysfunction and heart fail- ure.572,573 Calcium antagonists are useful in the treatment of angina. Many patients with SIHD will require a combination of drugs, including a diuretic, to achieve optimal BP control. Fihn et al Stable Ischemic Heart Disease: Full Text e397 The role of emotional stress in relationship to hypertension has yet to be fully elucidated. 