For patients 60 years and over with type 2 diabetes, we recommend treating to a systolic blood pressure goal of <140 mm Hg with added benefit to lowering systolic blood pressure further for those between 130 mm Hg and 140 mm Hg. (Strong for | Reviewed, Amended) Discussion As previously stated, pharmacologic treatment of HTN has been demonstrated to decrease the risk of major adverse cardiovascular events (MACE) such as CHD, stroke, heart failure, and overall mortality in patients with HTN, including patients with both HTN and diabetes.[54] Based on the SR and meta-analysis by Ettehad et al. (2016), pharmacologic treatment of HTN is associated with a 12% relative risk reduction for MACE in patients with diabetes per 10 mm Hg reduction in SBP.[54] This review demonstrated broad reduction in MACE regardless of baseline blood pressure down to an SBP of <130 mm Hg. Brunstr m et al. (2017) performed an SR of SRs with the purpose of determining the optimal blood pressure level and choice of antihypertensive agent in people with diabetes.[59] This study included 11 SRs (three SRs stratified according to baseline SBP, four SRs stratified by attained SBP, and eight SRs addressed choice of antihypertensive agent) and did not report the duration of follow-up for included studies. In these reviews, the mean age for patients was around 60 years. Evidence from Brunstr m et al. (2017) favored intensive blood pressure lowering in a general diabetic population when baseline SBP was >140 mm Hg. Achieving an SBP in the range of 130 to 140 mm Hg was associated with reduced CV events. A lower target of <130 mm Hg or treatment when the baseline SBP was <140 mm Hg was not, however, associated with statistically significantly improved cardiovascular outcomes or mortality. 