With an emphasis on BP con- trol in the broad context of secondary prevention measures, antihypertensive medication regimens and BP goals should be adapted to the individualized circumstances of each patient.198 BP patterns and the response to treatment can be best assessed with the use of home BP monitoring.229 Lifestyle measures such as exercise, reducing weight, and limiting sodium intake are useful adjunct measures in the post-CABG patient with hypertension. In addition, identifying comorbid risk factors for hypertension such as the BP change seen with post-CABG cognitive disorders, anxiety, depression, and sleep abnormalities and providing the indicated therapies can improve the overall effectiveness of the chosen antihyperten- sive therapies. No studies have prospectively evaluated the rapidity with which BP should be reduced in the post-CABG patient with hypertension. In addition, it is not known whether the J-curve relationship for morbidity and mortality occurs at a higher BP level in the post-CABG patient than in the patient without CAD. In the post-CABG patient with hypertension, the choice of antihypertensive agents and the order of their introduc- tion have not been methodically studied. Two major therapy groups, -blockers and ACE inhibitors, are routinely given Kulik et al Secondary Prevention After CABG 939 for their established cardioprotective features, as much as they are used for BP reduction.213,214 -Blockers should be administered as soon as possible after CABG in those patients without contraindications to reduce the risk of AF201,202 and to improve outcomes in those patients with congestive heart failure and LV dysfunction.205 However, their effect on BP has not been systematically explored. In the only randomized trial to date, Sjoland et al196 found no clinical benefit asso- ciated with a 2-year treatment with metoprolol after CABG. 