For many patients, benefits of intensive therapy seem to outweigh harms.[58,62] Yet, targeting an SBP goal of <130 does not mean that it must always be achieved; if older or particularly frail people develop side effects while titrating therapy to achieve this lower threshold, they may wish to have medications tapered back or changed. The patient focus group revealed that some patients do not want to take medications for treatment of HTN. This may limit the ability to achieve lower targets of SBP with intensive treatment, as this often requires multiple medications and may require frequent visits. Despite the conflicting evidence supporting an SBP goal of 130 mm Hg or less, the results from the SR by Ettehad et al. (2016) do demonstrate benefit in lowering SBP for those between 130 and 150 mm Hg.[54] Thus, there is strong evidence from one SR suggesting that lowering SBP by 10 mm Hg among people with an SBP above 130 mm Hg reduces the risk of cardiovascular events.[54] However, there are inconsistencies among other studies comparing a standard threshold with more intensive therapy. The evidence reviewed included very few adults under the age of 60, which, based on the GRADE methodology, resulted in a weaker recommendation. More intensive therapy often requires additional medications, which require further resources and which some people might prefer not to take. These results are in contrast to stronger evidence for the older population of age 60 who have hypertension, with or without diabetes (see Recommendation 7 and Recommendation 8). The research supporting the goal of SBP <130 mm Hg in the general HTN population, with or without diabetes, is less robust than higher thresholds, which, according to our methodology, resulted in a weaker recommendation for this SBP goal. 