Compared with non-Hispanic whites, hypertension occurs more commonly among African Americans, presents earlier, and is more severe. Recommended initial antihypertensive therapy in African American patients is a thiazide diuretic or a calcium channel blocker. An ACE inhibitor should be added on in African American patients with hypertension and co-morbid chronic kidney disease. Initial antihypertensive treatment with a beta-blocker or monotherapy with an ACE inhibitor or an ARB has been shown to be less effective for blood pressure reduction in African American patients than in white patients, so those agents are not appropriate for initial therapy.