An overview of RCTs showed that larger reductions in SBP tended to be associated with greater reduction in risk of recurrent stroke. However, a separate overview of RCTs in patients who experienced a stroke noted that achieving an SBP level <130 mm Hg was not associ- ated with a lower stroke risk, and several observational Whelton et al 2017 High Blood Pressure Clinical Practice Guideline e57 studies did not show benefit with achieved SBP levels 6. Patients with a lacunar stroke treated to an SBP target of <130 mm Hg versus 130 to 140 mm Hg may be less likely to experience a future ICH. 7. No published RCTs have specifically addressed this question, but a post hoc analysis of an RCT suggests that the effectiveness of antihypertensive treatment for sec- ondary stroke prevention diminishes as initial baseline 9.5. Peripheral Artery Disease Recommendation for Treatment of Hypertension in Patients With PAD References that support the recommendation are summarized in Online Data Supplement 45. COR LOE Recommendation I B-NR 1. Adults with hypertension and PAD should be treated similarly to patients with hypertension without PAD.S9.5-1 S9.5-4 Synopsis Patients with PAD are at increased risk of CVD and stroke. Hypertension is a major risk factor for PAD, so these patients are commonly enrolled in trials of antihypertensive drug therapy. However, patients with PAD typically comprise a small fraction of participants, so in the few trials that report results in patients with PAD, subgroup analyses are generally underpowered. Recommendation-Specific Supportive Text 1. 