T he prevalence of hypertension has continued to rise over the past decades, reaching 31.3% for 1999-2000, 1 possibly as the result of better detection and more specific definitions. only 37% of all patients with hypertension and only 57% of those receiving antihypertensive medication in the united states currently have controlled blood pressure (bp). 2 This is an improvement over prior years, as the national Health and nutrition Examination survey (nHanEs) iii indicated that during the time period of 1991 to 1994, only 22.7% of hypertensive patients had their bp controlled. 3 The current rate remains well below the Healthy people 2010 goal of 50%, set by the us Department of Health and Human services, however. 4 in 2003, the seventh report of the Joint national Committee on prevention, Detection, Evaluation, and Treatment of High blood pressure was published (JnC 7), which included the recommendation of thiazide diuretics for treatment of most patients with uncomplicated hypertension, either alone or in combination with drugs from other antihypertensive classes.5 JnC 7 recommended that thiazide diuretics be used as firststep therapy for hypertension management in the absence of high-risk conditions. Despite these