What do systematic reviews say?

First‐line thiazides vs alpha‐blocker

First‐line thiazides showed no clear difference in total stroke Duration: 3 to 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 0.86 [0.73, 1.01]
  2 studies · 24396 participants
  Moderate