Therefore, the recommendation is to choose thiazide- type diuretics over ACEI for black patients. Although a CCB was less effective than a diuretic in preventing heart failure in the black subgroup of this trial (question 3, evidence statement 14), there were no differences in other outcomes (cerebrovascular, CHD, combined cardiovascular, and kidney outcomes, or overall mortal- ity) between a CCB and a diuretic (question 3, evidence state- and CCBs are recommended as first-line therapy for hypertension in black patients. The panel recommended a CCB over an ACEI as first-line therapy in black patients because there was a 51% higher rate (relative risk, 1.51; 95% CI, 1.22-1.86) of stroke in black persons in ALLHAT with the use of an ACEI as initial therapy compared with use of a CCB (question 3, evidence statement 2).32 The ACEI was also less effective in reducing BP in black individuals compared with the CCB (question 3, evidence statement 2).32 There were no outcome studies meeting our eligibility criteria that compared diuretics or CCBs vs -blockers, ARBs, or other renin-angiotensin system inhibitors in black patients. Therecommendationforblackpatientswithdiabetesisweaker than the recommendation for the general black population be- causeoutcomesforthecomparisonbetweeninitialuseofaCCBcom- pared to initial use of an ACEI in black persons with diabetes were not reported in any of the studies eligible for our evidence review. Table 4. Evidence-Based Dosing for Antihypertensive Drugs Antihypertensive Medication Initial Daily Dose, mg Target Dose in RCTs Reviewed, mg No. of Doses per Day ACE inhibitors Angiotensin receptor blockers -Blockers Calcium channel blockers Thiazide-type diuretics Abbreviations: ACE, angiotensin-converting enzyme; RCT, randomized controlled trial. a Current recommended evidence-based dose that balances efficacy and safety is 25-50 mg daily. 