We read with interest the correspondence by Descamps et al.  They discuss several well-known studies concerning the need for a higher perioperative blood pressure threshold in hypertensive patients to prevent acute kidney injury. The primary outcome of our study was not a single adverse event, rather a composite of three (acute kidney injury, stroke, and mortality).  As previously reported from retrospective observational studies, blood pressure harm thresholds for different organs could differ.  Descamps et al. mention that individualizing blood pressure threshold from a patient’s baseline could improve outcomes. First, there is no clear consensus regarding a blood pressure threshold that could prevent adverse outcomes. Although some randomized studies in cardiac surgery did show that complications are lower in groups with high mean arterial pressure (MAP) compared with low-MAP groups,  other studies could not find any difference in adverse outcomes attributed to different MAP thresholds.  Descamps et al. also state that they are intrigued with the blood pressure threshold of MAP less than 65 mmHg. MAP less than 65 mmHg is frequently used to define intraoperative hypotension in both research and clinical practice. Moreover, this threshold has been found to be a population-based lower limit that could be associated with adverse outcomes.  In a retrospective observational study that included a large number of noncardiac surgical patients, associations with relative blood pressure thresholds from baseline (greater than 20% reduction) were no stronger than absolute thresholds (MAP less than 65 mmHg).  In our previous retrospective observational study, we found no associations between baseline pulse pressure and adverse outcomes.  Our point is, at this time, that the randomized data are limited. We need more prospective clinical trials to define clinically meaningful blood pressure thresholds and whether interventions to maintain blood pressure above these thresholds will affect clinical outcomes.