In blacks, thiazide-type diuretics and CCBs are more effective in lowering BP when given as monother- apy or as initial agents in multidrug regimens.S10.1.1-11 S10.1.1-13 In addition, thiazide-type agents are superior to drugs that inhibit the RAS (ie, ACE inhibitors, ARBs, renin inhibitors, and beta blockers) for prevention of selected clinical out- comes in blacks.S10.1.1-2,S10.1.1-14 S10.1.1-16 For optimum endpoint protection, the thiazide chlorthalidone should be administered at a dose of 12.5 to 25 mg/day (or 25 50 mg/d for hydro- chlorothiazide) because lower doses are either unproven or less effective in clinical outcome trials.S10.1.1-2,S10.1.1-16 The CCB amlodipine is as effective as chlorthalidone and more effective than the ACE inhibitor lisinopril in reducing BP, CVD, and stroke events but less effective in preventing HF. Blacks have a greater risk of angioedema with ACE inhibitors,S10.1.1-2,S10.1.1-3 and Asian Americans have a higher incidence of ACE inhibi- ACE inhibitors and ARBs are recommended more generally as components of multidrug antihypertensive regimens in blacks with CKD (see Section 9.3), with the addition of beta blockers in those with HF (see Section 9.2). Beta blockers are recommended for treatment of patients with CHD who have had a MI. Most patients with hypertension, especially blacks, require 2 antihypertensive medications to achieve adequate BP control. A single-tablet combination that includes either a diuretic or a CCB may be particularly effective in achieving BP control in blacks. Racial and ethnic differences should not be the basis for excluding any class of antihypertensive agent in combination therapy. Recommendation-Specific Supportive Text 1. In blacks, thiazide diuretics or CCBs are more effective in lowering BP than are RAS inhibitors or beta block- ers and more effective in reducing CVD events than are RAS inhibitors or alpha blockers. 