More adverse events (2% increase in absolute risk) were identified in the lower BP group, especially self-reported hypotension and a reduction in estimated GFR, but these did not result in an excess of stroke or ESRD. The ACCORD trial was a factorial study; secondary analysis demonstrat- ed a significant outcome benefit in the intensive BP/ standard glycemic group,S9.6-3 but benefit in the inten- sive BP/intensive glycemic control group was no bet- ter than in the intensive BP/standard glycemic control group, which suggests a floor benefit beyond which the combined intensive interventions were ineffective.S9.6-5 An ACCORD secondary analysis suggested that an SBP <120 mm Hg is superior to standard BP control in A meta-analysis of 73 913 patients with DM reported that an SBP <130 mm Hg reduced stroke by 39%. However, there was no significant risk reduction for MI.S9.6-23 Two meta-analyses addressing target BP in adults with DM restricted the analysis to RCTs that randomized patients to different BP levels.S9.6-4,S9.6-7 Target BP of 133/76 mm Hg provided significant benefit compared with that of 140/81 mm Hg for major cardiovascular events, MI, stroke, albu- minuria, and retinopathy progression.S9.6-4 Several meta- analyses of RCTs included all trials with a difference in but 2 restricted their analyses to trials in which participants were randomized to different BP target SPRINT demonstrated cardiovascular benefit from inten- sive treatment of BP to a goal of <120 mm Hg as compared with <140 mm Hg but did not include patients with DM. However, the results of ACCORD and SPRINT were generally In addition, a SPRINT substudy demonstrated that patients with prediabetes derived a benefit similar to that of patients with normoglycemia.S9.6-8 Previous trials have shown similar quantitative benefits from lowering BP in persons with and without DM.S9.6-9 2. 