What is the evidence for lowering systolic blood pressure to 140 mm Hg for individuals with diabetes and CKD?
The Work Group is confident that most individuals with diabetes and CKD should have their usual BP lowered to be consistently r140/90 mm Hg (hence the grade of 1B for recommendation 4.1). There is observational evidence that the risk of CVD is higher among diabetic patients than non-diabetic patients at any given BP, but these findings do not, in the absence of RCT evidence, support a recommendation that BP should be lowered further than is recommended in diabetic patients. International and national guidelines agree on a treatment goal of r140/ 90 mm Hg on the grounds that BP-lowering drugs reduce the risk of all-cause and cardiovascular mortality in people whose BP is 4140/90 mmHg.