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In a patient with well-controlled hypertension who is now targeting an aspirational systolic BP below 120 mmHg per the 2025 AHA/ACC guideline, how do you balance adding a medication against the risk of falls, syncope, and worsening renal function in practice?

2025 AHA/ACC Hypertension Guideline; SPRINT Research Group, NEJM 2015; Hypertension 2025 debate commentaries