Secondary analyses of the ACCORD trial demonstrated a sig- nificant outcome benefit of stroke risk reduction in the intensive BP/standard glycemic group.S4.4-74 6. The relationship of SBP with CVD risk is continuous across levels of SBP and similar across groups that differ in level of absolute risk.S4.4-55 The relative risk reduction attributable to BP-lowering medication therapy is consistent across the range of absolute risk observed in trials,S4.4-36 suggesting that rela- tive risk reduction may be similar at lower levels of absolute risk. Indirect support is also provided by evidence from trials using BP-lowering medica- tions to reduce the risk of developing higher levels In the HOPE-3 (Heart Outcomes Prevention Evaluation-3) BP Trial, there was no evidence of short-term benefit during treatment of adults (average age 66 years) with a relatively low risk of CVD (3.8% CVD event rate during 5.6 years of follow-up). However, subgroup analysis suggested benefit in those with an average SBP >140 mm Hg (and a CVD risk of 6.5% during the 7. The treatment of patients with hypertension with- out elevated risk has been systematically under- studied because lower-risk groups would require prolonged follow-up to have a sufficient number of clinical events to provide useful outcomes data. Although there is clinical trial evidence that both drug and nondrug therapy will interrupt the pro- gressive course of hypertension, there is no trial evi- dence that this treatment decreases CVD morbidity and mortality. The clinical trial evidence is strongest for a target BP of 140/90 mm Hg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from BP control earlier in life.S4.4-77 4.5. Treatment of Tobacco Use Recommendations for Treatment of Tobacco Use Referenced studies that support recommendations are summarized in Online Data Supplements 15 and 16. 