Additional details regarding the evidence quality rating system are available in the online Supplement. Clinical Review & Education Special Communication 2014 Guideline for Management of High Blood Pressure E4 JAMA Published online December 18, 2013 jama.com ManyparticipantsinthosestudiesachievedanSBPlower than 140 mm Hg with treatment that was generally well tolerated. suggesttherewasnobenefitforanSBPgoallower were wide and did not exclude the possibility of a clinically impor- tant benefit. Therefore, the panel included a corollary recommen- dationbasedonexpertopinionthattreatmentforhypertensiondoes not need to be adjusted if treatment results in SBP lower than 140 mmHgandisnotassociatedwithadverseeffectsonhealthorqual- ity of life. While all panel members agreed that the evidence supporting nimity on the recommendation of a goal SBP of lower than 150 mm Hg. Some members recommended continuing the JNC 7 SBP goal of lower than 140 mm Hg for individuals older than 60 years based on expert opinion.12 These members concluded that the evidence than 150 mm Hg in high-risk groups, such as black persons, those withCVDincludingstroke,andthosewithmultipleriskfactors.The panelagreedthatmoreresearchisneededtoidentifyoptimalgoals of SBP for patients with high BP. In the general population younger than 60 years, initiate pharma- cologic treatment to lower BP at DBP of 90 mm Hg or higher and treat to a goal DBP of lower than 90 mm Hg. 