Regardless of the strength of recommendations, but especially for weak recommendations, clinicians should understand the nature and rationale of the recommendations and engage in shared decision-making with the patients, as discussed above. Diastolic blood pressure as a target. The Work Group chose not to provide a target for DBP alongside the targeted SBP <120 mm Hg, although other guidelines often advocate targets for both SBP and DBP. The reasons for this decision are two-fold. First, for young patients with diastolic hypertension, it is essential to target DBP. Indeed, a number of earlier trials in the general population (e.g., ALLHAT) had explicit DBP as an inclusion criterion. However, wide pulse pressure, which is common in CKD implies that achievement of SBP <120 mm Hg will almost certainly result in DBP <70 mm Hg in the great majority of patients, making the provision of a separate DBP target redundant.141,155,156 Second, literature on RCTs targeting DBP with clinical outcomes is scarce, especially in the CKD population. Both MDRD and AASK studies employed a target MAP of <92 mm Hg, instead of an SBP and a DBP target, in the intensive BP arm, which is often considered equivalent to 125/75 mm Hg, but it is also gures, depending on the pulse pressure. As discussed earlier, these studies suggest that this intensive MAP target may provide renoprotective effects in proteinuric patients. Hence, it seems reasonable to target DBP of young patients with CKD and diastolic hypertension to <80 mm Hg, in addition to an SBP target <120 mm Hg. However, the Work Group is hesitant to recommend a DBP target because of the lack of evidence. Comparison with ACC/AHA guideline. 