Ethnicity and hypertension: not as black and white as NICE makes out

The updated guidance on the management of hypertension from the National Institute for Health and Clinical Evidence (NICE) suggests that initial monotherapy for all black patients should be calcium channel blockers, with thiazide diuretics as an alternative. 1 This is broadly in keeping with previous UK recommendations. Clinical events in high-risk hypertensive patients randomly assigned to calcium channel blocker versus angiotensin-converting enzyme inhibitor in the antihypertensive and lipid-lowering treatment to prevent heart attack trial.