What do systematic reviews say?

First‐line thiazides vs alpha‐blocker

First‐line thiazides probably leads to lower total congestive heart failure Duration: 3.2 years compared with first‐line alpha‐blockers (moderate certainty).

• First‐line diuretics versus other classes of antihypertensive drugs for hypertension 2023 · Cochrane Headline outcomes only
  RR 0.51 [0.45, 0.58]
  1 study · 24316 participants
  Moderate