The SR and meta-analysis by Ettehad et al. (2016) provides evidence in support of this recommendation.[54] This review included 78 RCTs comparing HTN treatment to placebo and 14 RCTs comparing intensive HTN treatment to standard treatment. The effect of a 10 mm Hg reduction on the relative risk of major cardiovascular events was estimated as a function of different baseline SBPs. Across a broad range of initial SBPs starting at greater than 130 mm Hg, a 10 mm Hg lowering in SBP was associated with improvements in the composite cardiovascular outcome. For people with diabetes, the SR and meta-analysis by Ettehad et al. (2016) showed pharmacologic treatment of HTN was associated with a 12% relative risk reduction for major adverse cardiovascular events (MACE) per 10 mm Hg reduction in SBP.[54] While this relative reduction in MACE is less than that observed in the non-diabetic population, the difference in impact between the diabetic and the non-diabetic population is neither statistically nor clinically significant. However, SRs limited to studies comparing a standard SBP threshold to a more intensive blood pressure threshold in HTN patients have arrived at contradicting conclusions, likely based on differences in inclusion criteria. The SR by Saiz et al. (2018) found no benefit of targeting an SBP threshold of 130 mm Hg when compared to a higher SBP threshold of 150 mm Hg.[55] This mirrors the findings from the SR by Weiss et al. (2017) that looks at studies targeting a lower threshold.[56] In contrast, the SR by Reboussin et al. (2018) found significant reductions in the risk of major cardiovascular events associated with an SBP target of less than 130 mm Hg.