In most people with high BP, including the frail and elderly, these bene ts appear to outweigh the risks of harm (e.g., hypotension and acute kidney injury [AKI]). However, empirical evidence demonstrating how individuals would weigh these bene ts and harms is lacking. These bene ts extend to patients with or without CKD. Still, there is less certainty that the bene ts outweigh the harms with the following scenarios:  CKD G4 and G5: For people with a lower GFR, there is less certainty around the bene t of lower BP target and po- tential risk of harm, compared to people with higher GFRs.  Diabetes: The bene ts of intensive BP lowering are less certain among patients with concomitant diabetes and CKD, compared to patients with CKD without diabetes.  Individuals with SBP of 120 129 mm Hg: Observational data suggest that individuals with SBP of 120 129 mm Hg are at higher CV risk than those with SBP <120 mm Hg.94 Lowering the SBP from 120 129 mm Hg to <120 mm Hg may therefore be bene cial hypothetically. However, RCTs in CKD targeting SBP <120 mm Hg have not included individuals with SBP of 120 129 mm Hg. Therefore, the recommendation of lowering SBP from 120 129 mm Hg to <120 mm Hg by pharmacologic or non-pharmacologic means is tentative.  People with very low baseline DBP (e.g., <50 mm Hg), particularly in the presence of coronary artery disease: In theory, it is possible that intensive BP lowering will increase the risk of myocardial infarction (MI) in this subgroup because coronary perfusion depends on DBP. However, in SPRINT, the subgroup with the lowest DBP at baseline had similar CV and survival bene ts from intensive SBP reduction as those with higher baseline DBP. 