Efficacy of Different Drug Classes Used to Initiate Antihypertensive Treatment in Black Subjects

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Abstract
SIMILAR TO the recommendations of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure,1 the South African guidelines for antihypertensive therapy2 recommend the use of low-dose thiazides as the preferred first-line drug, to which calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or reserpine may be added to achieve blood pressure (BP) control. Although many patients with mild to moderate hypertension require more than 1 drug to reach normal BP,3 it remains unclear what proportion of black patients with hypertension can be controlled in the long-term if thiazides or other drug classes are used to initiate treatment.

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