Format for guideline recommendations. Each chapter contains one or more specific recommendations. Within each recommendation, the strength of recommendation is indicated as level 1 or level 2 and the quality of the supporting evidence is shown as A, B, C, or D. The recom- mendation statements and grades are followed by a brief background with relevant definitions of terms and then the rationale starting with a chain of logic, which consists of declarative sentences summarizing the key points of the Table 16 | Continued Year Group Target CKD population Recommended BP goal (mm Hg) Recommended preferred anti-hypertensive agent(s) 2011 The Renal Association (UK) CKD Guidelines396 http://www.renal.org/Clinical/GuidelinesSection/ Detection-Monitoring-and-Care-of-Patients-with-CKD.aspx CKD For the majority, systolic BP: o140 mm Hg (target range 120 139 mm Hg) and diastolic BP: o90 mm Hg for the majority ACE-I or ARB For those with DM or proteinuria X1g/24 h, systolic BP: o130 mm Hg (target range 120 129 mm Hg) and diastolic BP: o80 mm Hg unless the risks are considered to outweigh the potential benefits Antihypertensive therapy should be individualized and lowering the systolic blood pressure to o120 mm Hg should be avoided 2012 Canadian Hypertension Education Program Recommendations http://www.hypertension.ca/chep-recommendations Non-DKD and DKD CKD in general: o140/90 Non-DKD: ACE-I or ARB (if ACE-I intolerant) as a first choice agent if urine ACR 430 mg/mmol (4300 mg/g) or urine protein 4500 mg/24 h DKD: For patients with persistent microalbuminuria (urine ACR 42 mg/mmol [420 mg/g] in men and 42.8 mg/mmol [428 mg/g] in women), ACE-I or or ARB is recommended as initial therapy DM with microalbuminuria or overt nephropathy o130/80 ACE-I or ARB should be considered for patients with microalbuminaria or macroalbuminaria. 