The most recent National Heart, Lung, and Blood Institute appointed panel provides an evidence-based approach to pharma- cological treatment of hypertension.220 The report focuses on age as a guide for therapeutic targets, with recommendations to lower BP pharmacologically to a target of <150/90 mmHg for patients >60 years of age and target a BP of <140/90mmHg for younger patients. However, these recommendations differ from the 2014 science advisory on high BP control endorsed by the AHA, ACC, and Centers for Disease Control and Prevention in which more aggressive BP targets are recommended (<140/90 mmHg) regardless of age.218 There is concern that raising the SBP thresh- old from 140 to 150 mmHg might reverse some of the gains that have been achieved in reducing stroke by tighter BP control. For patients with diabetes mellitus who are at least 18 years of age, the panel originally appointed by the National Heart, Lung, and Blood Institute to review the evidence on treatment of hyperten- sion recommends initiating pharmacologic treatment to lower BP at SBP of 140 mmHg or DBP of 90 mmHg and to treat to a goal SBP of <140 mmHg and a goal DBP <90 mmHg.220 The International Society on Hypertension in Blacks revised its recommendations for managing BP in this at-risk population in 2010.259 In the absence of target-organ damage, the target should be <135/85 mmHg; in the presence of tar- get-organ damage, the target should be <130/80 mmHg. For patients who are within 10 mmHg above target, monotherapy with diuretic or calcium channel blocker is preferred, and for patients >15/10 mmHg above target, 2-drug therapy is pre- ferred either with a calcium channel blocker plus renin-angio- tensin system blocker or, in edematous or volume-overloaded states, with a thiazide diuretic plus a renin-angiotensin system blocker. 