Until the International Verapamil-Trandolapril Study (INVEST) trial, the only evidence of benefit from using hypertensive agents for patients for coronary artery disease was from subgroup analyses of existing clinical trials. The INVEST trial was the first major trial primarily designed to study hypertensive patients with established coronary artery disease. The multicenter, multicountry, randomized, open-label, blinded, end point study involved 22 576 hypertensive patients with coronary artery disease 50 years of age or older. The patients received either a calcium antagonist strategy (verapamil sustained-release) or a non–calcium antagonist strategy (atenolol). (β-Blockers are the only class of agents approved for secondary cardioprotection, although ACE inhibitors may soon gain approval.) Concomitant therapies—trandolapril or hydrochlorothiazide—were added as needed to reduce blood pressure to 140/90 mm Hg. If diabetes or renal impairment were present, the target blood pressure was 130/85 mm Hg. Also, trandolapril was recommended for patients with heart failure, diabetes, or renal impairment. The primary outcome of the study was a composite end point of death from any cause, nonfatal myocardial infarction, or nonfatal stroke.