The totality of the available information pro- vides evidence that a lower BP target is generally better than a higher BP target and that some patients will benefit from an SBP treatment goal <120 mm Hg, especially those at high risk The specific inclusion and exclusion criteria of any RCT may limit extrapolation to a more general population with hypertension. In addition, all of the relevant trials have been efficacy studies in which BP measurements were more consistent with guideline recommendations than is common in clinical practice, resulting in lower absolute values for SBP. For both of these reasons, the SBP target recommended dur- ing BP lowering (<130 mm Hg) is higher than that which was used in SPRINT. Recommendation-Specific Supportive Text 1. Meta-analysis and systematic review of trials that com- pare more intensive BP reduction to standard BP reduc- tion report that more intense BP lowering significantly reduces the risk of stroke, coronary events, major cardio- vascular events, and cardiovascular mortality.S8.1.5-1 In a stratified analysis of these data, achieving an additional 10 mm Hg reduction in SBP reduced CVD risk when compared with an average SBP of 158/82 to 143/76 mm Hg, 144/85 to 137/81 mm Hg, and 134/79 to 125/76 mm Hg. Patients with DM and CKD were included in (Specific man- agement details are in Section 9.3 for CKD and Section 9.6 for DM.) 2. The treatment of patients with hypertension without ele- vated risk has been systematically understudied because lower-risk groups would require prolonged follow-up to have a sufficient number of clinical events to provide useful information. Although there is clinical trial evi- dence that both drug and nondrug therapy will interrupt the progressive course of hypertension,S8.1.5-6 there is no trial evidence that this treatment decreases CVD mor- bidity and mortality. 