[64-68] The Work Group determined the confidence in the quality of the evidence was high in support of intensive treatment of HTN in a general population of patients with diabetes. The benefits of treatment clearly outweigh the harms, though we do note that there is variance in acceptance of intensive treatment from providers and patients and many patients may not be willing to take multiple medications to achieve target SBP levels. The evidence included in the SR conducted as part of this guideline update is primarily from patients with diabetes type 2 who are already on pharmacologic antihypertensive treatment. These patients typically are middle-aged or elderly (but under the age of 80 years). There is little evidence for pharmacologic treatment to a target SBP in patients with type 1 diabetes, adults under the age of 50, or the very old (over 80 years). Future research on any of these subgroups may provide additional evidence regarding appropriate blood pressure goals. Recommendation 9. For patients 30 years and over, we recommend treating to a diastolic blood pressure goal of <90 mm Hg. (Strong for | Reviewed, Amended) Discussion This recommendation is supported by strong clinical trial evidence demonstrating the benefits of treating HTN to a DBP goal of less than 90 mm Hg and was carried forward from the 2014 VA/DoD HTN CPG. Landmark studies, such as the Veterans Administration Cooperative Study Group on Antihypertensive Agents, the Hypertension Detection and Follow-up Program (HDFP), and the Medical Research Council (MRC) trial of treatment of mild HTN, all demonstrated substantial benefits in terms of reduced cardiovascular events by treating to a target DBP of less than 90 mm Hg.[69-73] Eligibility for these studies differed slightly, but all included patients 30 years of age or older. 