First, many people will require treatment with more than one antihyperten- sive drug to achieve BP control. While this recommendation ap- pliesonlytothechoiceoftheinitialantihypertensivedrug,thepanel agents (recommendation 9). Second, this recommendation is spe- cific for thiazide-type diuretics, which include thiazide diuretics, chlorthalidone, and indapamide; it does not include loop or potas- sium-sparing diuretics. Third, it is important that medications be dosedadequatelytoachieveresultssimilartothoseseenintheRCTs (Table 4). Fourth, RCTs that were limited to specific nonhyperten- sivepopulations,suchasthosewithcoronaryarterydiseaseorheart failure,werenotreviewedforthisrecommendation.Therefore,rec- ommendation 6 should be applied with caution to these popula- tions. Recommendations for those with CKD are addressed in rec- ommendation 8. In the general black population, including those with diabetes, ini- tial antihypertensive treatment should include a thiazide-type di- uretic or CCB. Forgeneralblackpopulation:ModerateRecommendation GradeB For black patients with diabetes: Weak Recommendation Grade C tion 3. In cases for which evidence for the black population was the sameasforthegeneralpopulation,theevidencestatementsforthe general population apply to the black population. However, there are some cases for which the results for black persons were differ- ent from the results for the general population (question 3, evi- dence statements 2, 10, and 17). In those cases, separate evidence statements were developed. This recommendation stems from a prespecified subgroup analysis of data from a single large trial (ALLHAT) that was rated In that study, a thiazide-type diuretic was shown to be more effective in improving cerebrovascular, heart failure, and combined cardiovascular outcomes compared to an ACEI in the black patient subgroup, which included large numbers of diabetic and nondiabetic participants (question 3, evidence statements 10, 15 and 17). Therefore, the recommendation is to choose thiazide- type diuretics over ACEI for black patients. 