To provide a quick reference for practicing clinicians, these are summarized for hyperten- sive patients in general and for those with specific comorbidi- ties in Table 23. 15. Evidence Gaps and Future Directions In the present guideline, the writing committee was able to call on the large body of literature on BP and hypertension to make strong recommendations across a broad range of medical con- ditions. Nonetheless, significant gaps in knowledge exist. Importantly, there are areas where epidemiological and natural history studies suggest that hypertension prevention or earlier treatment of hypertension might substantially improve outcomes, but clinical trials are lacking to provide guidance. The combination of epidemiological data showing a graded relationship between BP and outcomes, particularly above a BP of 120/80 mm Hg, and the results of the SPRINT trial showing benefit of more comprehensive treatment to a target BP of <120/80 mm Hg, suggests that a lifelong BP below that level will substantially lower CVD and CKD incidence. This is especially the case for younger individuals, those with DM, and those with high lifetime CVD risk based on the presence of multiple risk factors, including high BP. If hard, cardiovascular outcome clinical trials remain the sole driver of evidence-based guidelines, then determining the full benefit of earlier interven- tion may not be possible because of the cost and length of time needed for intervention. Outcomes may be different if antihy- pertensive treatment is initiated earlier in the natural history of CVD. DM may provide a population in whom to test this hypothesis. Composite outcomes that include both prevention of events and surrogates, such as prevention of decline in renal function or amelioration of measures of subclinical atheroscle- rosis, vascular stiffness, or LV structure and function, should be considered. 