Treatment with a thiazide-type diuretic or an ACE in- hibitor has been shown to be more effective than treat- ment with a calcium channel blocker in improving HF Although the writing committee recognized that improved HF outcome was an important finding that should be considered in the selection of a drug for initial therapy for hypertension, the panel did not conclude that it was compelling enough to preclude the use of the other drug classes for initial therapy. The panel also acknowl- edged that the evidence supported BP control, rather than a specific agent used to achieve that control, as the most relevant consideration for their recommendation.7 Supporting this, historically, most antihypertensive drugs have demonstrated comparable cardiovascular efficacy Specifically, diuretic-based antihyperten- sive therapies have been shown to prevent HF in a wide range of target populations as first-line therapy.27,35 39 Additionally, low-dose diuretics have been shown to be more effective as a first-line treatment for preventing the development of HF compared with ACE inhibitors, -blockers, or calcium channel blockers by meta-analy- It should also be noted that most of the original tri- als used the longer-acting chlorthalidone rather than hy- drochlorothiazide. 