What is the first choice for blood pressure treatment?

Following the new definition in the 2017 American College of Cardiology/American Heart Association hypertension guideline, 103·3 million adults in the USA now have hypertension.1 The majority of these people are candidates for pharmacological antihypertensive therapy. Health-care providers faced with the question of which medication to prescribe first for newly diagnosed patients get little help from current hypertension guidelines. These guidelines recommend multiple first-line drug classes, including thiazide or thiazide-like diuretics (THZs), angiotensin converting-enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs),2,3 and, in some cases, β blockers.