Antihypertensive therapy usually should not be initiated with diuretics, as this tends to result in the need for a greater number of medications while not achieving better blood pressure control.
COMMENT: this is an interesting study, however, current recommendations still suggest that it is appropriate to initiate antihypertensive therapy with diuretics in many cases (reference: epocrates "essential hypertension" and uptodate.com article "Choice of therapy in primary (essential) hypertension: Recommendations", both accessed 1/28/2014). Right now, I usually default to an ACE inhibitor plus lifestyle recommendations (primarily more exercise)
