In Reply We agree with Dr Casey and colleagues that the 2025 AHA/ACC multisociety guideline’s BP goal of less than 130/80 mm Hg should be the national goal. We also agree that the previous BP goal of 140/90 mm Hg, which is included in many national quality metrics, is outdated and that the higher BP levels in quality performance measures may contribute to gaps between evidence and clinical practice. Estimates suggest that achieving and maintaining a BP goal of 130/80 mm Hg among US adults could prevent 500 000 more CVD events nationally during 10 years compared with a goal of 140/90 mm Hg.