Diuretics and beta-blocking agents have been used for several years as first-step drugs in the treatment of hypertension. There is now growing evidence that calcium channel blockers and angiotensin converting enzyme inhibitors can also be administered as first-line antihypertensive agents. These agents offer attractive features from the hemodynamic and metabolic viewpoint and with regard to side effects. Diuretics, beta-blocking agents, calcium channel blockers and angiotensin converting enzyme inhibitors, administered either alone or in combination, normalize blood pressure in almost all hypertensive patients.