You regularly encounter tren users in your clinical practice and have tried various BP meds on them?
Yes, in some places, thiazide diuretics are still the preferred first-line treatment
in your average hypertensive patient. Tren using bodybuilders are not your average patient and the underlying cause of their hypertension is very different. Consequently, the treatment approach needs to be adjusted.
In addition to the questionable efficacy of thiazides in AAS abusing bodybuilders, there are serious side effects. Chiefly among them is renal injury due to long-term diuretic use. AAS abusing bodybuilders are already extremely prone to kidney damage (see
http://www.professionalmuscle.com/f...6855-maintaining-kidney-health-while-aas.html), so thiazides may well push them over the edge into kidney failure. Then there's thiazides causing hyperlipidemia and worsening insulin resistance, lowering exercise performance, etc. See for a discussion of the side efects:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903051/
Thiazides are not a good drug to take, in particular for bodybuilders. Luckily, treatment guidelines in some countries have already removed them as the recommended first-line treatment. In any case, you should practice
evidence-based medicine and thus base your treatment choice on the scientific evidence and not on your clinical experience (i.e. anecdotal evidence). Then you would maybe understand that ARBs + 3rd gen beta blockers are not only more effective, but also vastly less risky.