Do we need another antihypertensive agent? The factors to be considered in selecting antihypertensive agents have traditionally centered around balancing efficacy against adverse side effects. The former can be achieved by a variety of agents alone or in combination. The latter not only involves safety but is also concerned with whether an otherwise safe agent is tolerated by the patient so compliance with the treatment regimen can be achieved. A relatively new consideration is how antihypertensive agents affect other disease states that may or may not be associated with hypertension. For example, how a drug may affect diabetes, gout, myocardial hypertrophy, atherosclerosis, and coronary events must be evaluated. These concerns taken together answer the question of why yet another antihypertensive agent may be needed in the pharmacologic armamentarium. 