Which class of antihypertensive medications is considered first-line for patients with coronary artery disease (CAD)?

Beta blockers are considered the first-line antihypertensive medications for patients with coronary artery disease (CAD) primarily because they reduce the heart's workload and lower myocardial oxygen demand. This is particularly beneficial for patients with CAD, as it helps prevent angina and decreases the risk of heart-related complications. Beta blockers also have a protective effect after a myocardial infarction and help to improve survival rates in these patients.

While other classes like ACE inhibitors and ARBs may also be beneficial in managing hypertension and provide additional renal protective effects, beta blockers are specifically recommended in the context of CAD, especially in patients who have experienced events like a heart attack. Calcium channel blockers, while useful in some hypertension cases, do not have the same level of evidence supporting their use in CAD as first-line therapy compared to beta blockers.