This more intensive or aggressive approach often requires additional medications which, in turn, require further resources and which some people might not prefer. Benefits of intensive therapy seem to outweigh harms.[58,62] Attempts at lowering systolic blood pressure further for those between 130 mm Hg and 150 mm Hg in order to achieve lower threshold goals is not always feasible; if older or particularly frail people develop side effects while titrating therapy to achieve lower blood pressures, they may wish to have medications tapered back or changed. As this is a Reviewed, Amended recommendation, the Work Group systematically reviewed evidence identified in the evidence review conducted as part of this guideline update.[54-58] For people with an SBP between 130 and 150 mm Hg, there is high confidence in the quality of evidence that additional reductions in blood pressure are beneficial. This is supported by the SR by Ettehad et al. (2016) which found that a 10 mm Hg reduction in SBP was associated with improved cardiovascular outcomes [54] and by the findings of the SR by Reboussin et al. (2018).[57] There is some inconsistency in the data, as not all SRs support further lowering of SBP across all patient groups. The benefit of improved cardiovascular outcomes outweighs the potential harm of adverse events, and patients are generally accepting of HTN therapy. Some patients, though, are concerned about the AEs of medication and may indicate that they want to avoid or limit use of medications, when possible. Recommendation 8. For patients 60 years and over with type 2 diabetes, we recommend treating to a systolic blood pressure goal of <140 mm Hg with added benefit to lowering systolic blood pressure further for those between 130 mm Hg and 140 mm Hg. 