Although we would have preferred to give a target range (lowest to highest) for BP rather than a single target for highest acceptable BP, there are insufficient data based on RCTs to recommend a target for lowest BP level. The recommendations and suggestions in this chapter therefore emphasize an approach based on highest acceptable BP and severity of albuminuria, but the interventions should be implemented cautiously and with subsequent surveillance for adverse effects. We also recognize that BP agents other than those recommended or suggested below, such as diuretics, may be necessary for BP control, especially as CKD progresses and volume retention becomes more of an issue. However, few RCTs addressing hard cardiovascular or kidney outcomes have randomized patients to a diuretic versus another agent on top of an ACE-I or ARB. Therefore, in contrast to the we do not provide a guideline statement regarding diuretic use as a preferred second-line agent. The use of diuretics and other BP agents are discussed in more detail below and in Chapter 2. 3.1: We recommend that non-diabetic adults with CKD ND and urine albumin excretion o30 mg per 24 hours (or equivalent*) whose office BP is consistently 4140 mm Hg systolic or 490 mm Hg diastolic be treated with BP-lowering drugs to maintain a BP that is consistently r140mmHg systolic and r90 mm Hg *Approximate equivalents for albumin excretion rate per 24 hours expressed as protein excretion rate per 24 hours, albumin/creatinine ratio, protein/creatinine ratio, and protein reagent strip results are given in Table 1, Chapter 1. RATIONALE K High BP is a risk factor for CVD and development and progression of CKD. K Lowering BP in the general population reduces cardio- vascular risk. K Lowering BP in CKD patients reduces the rate of CKD progression. 