Hypertension causes atheroma formation and athero¬sclerosis. A significant number of patients with angina have hypertension: blood pressure greater than 140 or pressures in the high normal range of 135–140 systolic mmHg. Hypertension causes an increased thickness of the left ventricular muscle, which requires more blood and oxygen to function. Hypertension must be aggressively controlled. The best antihypertensive agents for patients with angina are beta-blockers and ACE inhibitors. ACE inhibitors are particularly useful because they dilate the arterial circulation and rest the myocardium without stimulating the heart to beat at a faster rate or to require more oxygen. Other vasodilators that include OL1-adrenergic blockers, such as terazosin, increase heart rate and ejection velocity and are contraindicated in patients with CAD. These agents may increase the incidence of heart failure. A randomized clinical trial the HOPE study; see the Bibliography indicates that ACE inhibitors improve survival in patients with CAD.