Trial results should be interpreted for the entire study cohort, with effect modi ca- tion by factors de ning subgroups examined in secondary analysis. Such effect modi cation was not noticed for CKD in SPRINT. Regardless, SPRINT is the largest trial testing 2 BP targets in CKD with approximately 2600 CKD patients. Although SPRINT excluded patients with diabetes, polycystic kidney disease, or proteinuria $1 g/d, those with glomeru- lonephritis not taking immunosuppressive medications were not excluded. Three other trials comparing different BP targets, powered for kidney outcomes as primary outcomes, generated far too few CV events or death outcomes (MDRD, AASK, REIN-2). However, a meta-analysis by Malhotra et al., examining death as an outcome exclusively in the CKD subgroups of the large hypertension treatment RCTs, also found a bene t of lower target BP.111 Older adults with or without CKD. There are meta-analyses and systematic reviews based on the general population of older adults, including patients with CKD, addressing the impact of lower BP targets. Garrison et al. analyzed RCTs conducted in hypertensive adults aged 65 years or older and reported outcomes for higher SBP (150 160 mm Hg) or DBP (95 105 mm Hg), compared to a lower treatment target SPRINT was excluded from this analysis because its lower target was lower than the inclusion criteria of the meta-analysis. Its inclusion may have changed the results of the meta-analysis. Based on this meta-analysis, there was insuf cient evidence to determine whether a lower SBP target provides meaningful differences in bene ts or harms to older adults. However, there are very few major trials and relatively few events in this meta-analysis. In contrast, Bavishi et al. 