Trandolapril, hydrochlorothiazide, or both were added to achieve either a BP o140/90mm Hg or a BP of o130/85mm Hg in patients with diabetes or kidney impairment.230 In an analysis of achieved BP among participants with diabetes (irrespective of their rando- mized treatment assignments), those who achieved tight BP control (i.e., a systolic BP o130mm Hg) had similar rates of cardiovascular outcomes, and higher rates of death, than those with usual BP control (i.e., systolic BP, 130 to 140mm Hg). Both groups had better outcomes than did a third group with poor BP control (i.e., systolic BP 4140 mm Hg). The increased risk of mortality in the tight-control group persisted during an extended follow-up period.231 The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (AD- VANCE) collaborative group showed that the addition of perindopril plus indapamide to current therapy used in patients with type 2 diabetes and high cardiovascular risk reduced the rate of major or microvascular events.232 In a secondary analysis, kidney events (mostly measures of appearance or worsening of urinary AER) were less frequent with a lower achieved BP at the follow-up visit.233 The absolute risk reductions for cardiovascular and kidney end points associated with active treatment (irrespective of BP) were greater among patients with CKD 3 5 than among patients with CKD 1 2.234 Interpretation. 