K BP lowering reduces the rate of urinary albumin excretion, which may in turn lead to a reduced risk of both kidney and cardiovascular events, although this has not been shown in RCTs. RCTs. The Work Group found only one RCT, from the Steno Diabetes Centre in Copenhagen (Intensified Multi- factorial Intervention in Patients With Type 2 Diabetes and Microalbuminuria [Steno-2 study]) in which diabetic patients with high urine albumin were selected and randomized to two BP targets.209,211,253 In the Steno-2 study, 160 adults with microalbuminuria and type 2 diabetes were randomized to intensive multifactorial intervention or to conventional therapy. The intensive-care arm received ACE-I or ARB irrespective of BP and had a BP target that was initially 140/85 mm Hg but was reduced to 130/80 mm Hg during the study, as compared to o160/95 mm Hg which was subsequently reduced to o135/85 mm Hg in the conven- tional arm. However, intensive intervention also included dietary advice, exercise, lipid-lowering treatment, help with smoking cessation, vitamin supplementation, aspirin, and intensified glycemic control. This intensive therapy was shown to be associated with a reduced risk of CVD, nephropathy, retinopathy, and autonomic neuropathy. The improvements seen in the intensive-therapy group were mostly in BP and the lipid profile, with only minor differences between the two groups in glycemic control and no differences in smoking, exercise measures, or body Observational evidence. 