In SPRINT, a more intensive intervention that targeted an SBP <120 mm Hg significantly reduced the primary outcome (CVD composite) by about 25%.S9.2-9 The in- cidence of HF, a component of the primary outcome, was also substantially decreased (hazard ratio: 0.62; 95% confidence interval: 0.45 0.84). Meta-analyses of clinical trials have identified a similar beneficial ef- fect of more-intensive BP reduction on the incidence of but the body of information from stud- ies confined to trials that randomly assigned partici- pants to different BP targets is more limited and less In addition, the available trials were effi- cacy studies in which BP measurements were more con- sistent with guideline recommendations than is common in clinical practice, resulting in lower absolute values for SBP. For both of these reasons, the SBP target recom- mended during BP lowering (<130 mm Hg) is higher than that used in SPRINT. 9.2.1. Heart Failure With Reduced Ejection Fraction Recommendations for Treatment of Hypertension in Patients With HFrEF References that support recommendations are summarized in Online Data Supplement 34. COR LOE Recommendations I C-EO 1. Adults with HFrEF and hypertension should be prescribed GDMTS9.2.1-2 titrated to attain a BP of less than 130/80 mm Hg. III: No Benefit B-R 2. Nondihydropyridine CCBs are not recommended in the treatment of hypertension in adults with HFrEF.S9.2.1-1 Synopsis Approximately 50% of patients with HF have HFrEF.S9.2.1-2 S9.2.1-6 Numerous RCTs have shown that treatment of HFrEF with GDMT reduces mortality and HF hospitalizations.S9.2.1-7 Large-scale RCTs have shown that antihypertensive drug therapy reduces the incidence of HF in patients with In ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), chlorthalidone reduced the risk of HFrEF more than amlo- dipine and doxazosin but similarly to lisinopril.S9.2.1-12,S9.2.1-13 Recommendation-Specific Supportive Text 1. 