The preventive effects of antihypertensive drugs on cardiovascular disease are determined by the degree to which blood pressure decreases rather than its class. Appropriate antihypertensive drugs should be selected considering compelling indications, contraindications and conditions that require the careful use of drugs and the presence or absence of complications. In hypertensive patients without compelling indications, the antihypertensive drug to be first administered should be selected from Ca channel blockers, angiotensin-receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors and diuretics. The use of two or three drugs in combination is often necessary to achieve the target of blood pressure control. Combination therapy with different classes of antihypertensive drugs exhibits potent hypotensive effects, and is useful for achieving the target of blood pressure control.