Thiazide diuretics are first-line therapy unless there is a compelling indication for alternative treatment; such as beta-blockers (use with caution with atazanavir) or angiotensin-converting enzyme (ACE) inhibitors for heart failure; beta-blockers or calcium-channel blockers (start with low doses of amlodipine, nifedipine, and verapamil in HIV-infected patients) for ischemic heart disease; ACE inhibitors or angiotensin receptor blockers (ARBs) for chronic kidney disease and diabetes; and ARBs or ACE inhibitors for left ventricular hypertrophy. The gene discussed is ACE; the disease is heart failure.