People who have had a stroke, because there was limited evidence that lower blood pressure targets reduced the risk of future strokes, but there was also evidence on the possible harms of lower targets. Evidence for both potential benefit and harm was too limited to inform a recommendation. How the recommendations might affect practice The new recommendation reflects current practice for most types of cardiovascular disease, so there should be no change in practice or increase in resource use. The Royal College of Physicians Intercollegiate Stroke Working Party guideline recommends a lower blood pressure target for people after stroke. However, the national quality indicators used in primary care do not use a lower blood pressure target for people with cardiovascular disease (including stroke and transient ischaemic attack). Return to recommendation Choosing antihypertensive drug treatment for people with cardiovascular disease Why the committee made the recommendation New evidence in this area was not reviewed as part of the 2022 update. Instead, the evidence from previous versions of the guideline was reassessed to look at outcomes for people with cardiovascular disease. Only evidence up to 2010 was re-analysed, because the 2019 update did not review evidence for people with cardiovascular disease. There was no difference in clinically relevant outcomes between people with and without cardiovascular disease. Evidence was limited for people with stroke, transient ischaemic attack, or coronary artery disease. This evidence did not cover enough treatment comparisons to allow the committee to draw any firm conclusions. There are NICE guidelines on acute coronary syndromes and chronic heart failure, and these guidelines make recommendations on drug treatment that overlap with treatment for hypertension. 