[69-73] Eligibility for these studies differed slightly, but all included patients 30 years of age or older. Based on the SR and meta-analysis by Saiz et al. (2018), lower target DBP goals showed no treatment benefit in mortality or cardiovascular This recommendation may or may not apply to patients aged 18 to 29 as clinical trials did not include patients younger than 30. However, it is unlikely that clinical trials will address HTN treatment and optimal DBP targets in younger adults given the low prevalence of primary HTN in younger adults. The Work Group believes that younger adults with elevated DBP may also benefit from treatment. The patient focus group revealed that some patients are resistant to taking medications, and lower targets generally require more medications and more clinical follow-up. Therefore, patients should find this recommendation acceptable. However, providers may note this recommendation differs from other recent HTN guidelines; therefore, our guidance may be confusing. The Work Group feels it is important to highlight for providers that there are no new RCTs providing evidence to lower the DBP target to less than 90 mm Hg (e.g., 80 mm Hg), and recommendations for a lower DBP target in other HTN guidelines are based on expert opinion. Both of these should give providers reassurance in this recommendation when considering treatment. The Work Group, however, did not believe it likely that there would be harm for DBPs treated to lower levels, especially when treating SBP to the appropriate goal.[74] As this is a Reviewed, Amended recommendation, the Work Group systematically reviewed evidence related to this recommendation in the evidence review conducted as part of this guideline update,[55] as well as considered evidence from the 2014 VA/DoD HTN CPG.