Table 16.

Recommendations for the management of hypertension with acute stroke and cerebrovascular disease. BP: blood pressure; CCB: calcium channel blockers; IV: intravenous; RAS: renin-angiotensin system; SBP: systolic blood pressure.

Class	Recommendation
	Antihypertension medication is recommended immediately after transient ischemic attack and after few days of ischemic stroke.
	A RAS blocker in combination with a CCB or a thiazide-like diuretic is recommended for stroke prevention
	Immediate BP lowering should be considered intravenously to reach a target of SBP<180mmHg in people with acute intracerebral hemorrhage and SBP ≥ 220mmHg.
	BP should be lowered to <180/105mmHg in people with acute ischemic stroke who are eligible for IV thrombolysis. BP should be maintained in this range in the first 24 hours after thrombolysis.
	The SBP of people who suffered a transient ischemic attack or an ischemic stroke should be maintained at 120–130 mmHg.
	Antihypertensive medication may be considered to reduce BP during the first 24 hours after stroke onset in people with high BP not receiving fibrinolysis.
	Acute intravenous BP lowering is not recommended in people with acute intracerebral hemorrhage and SBP <220mmHg.
	Routine BP lowering is not recommended in people with acute ischemic stroke.