TABLE 2.

Summary of blood pressure thresholds and targets for persons with stroke

Context	BP threshold for initiating pharmacotherapy	Blood pressure targets	Preferred agents
In‐hospital Mgt	Refer to Neurologist for specialist management		Intravenous titratable anti‐hypertensives
Acute Ischemic Stroke (AIS), eligible for IV thrombolysis but not for mechanical thrombectomy	>185/110 mm Hg	<185/110 mm Hg prior to thrombolysis and during infusion; 180/105 mm Hg in the next 24 h	Nicardipine 1–5 mg/h IV, titrate up by 2.5 mg/h every 5–15 min, with maximum of 15 mg/h. If available: alternative of labetalol 10 mg IV over 1–2 min followed by continuous IV infusion of 2–8 mg/min.
AIS, not eligible for IV thrombolysis or mechanical thrombectomy	Severe hypertension: SBP of > 220 mm Hg DBP of > 120 mm Hg	If with severe hypertension, reduce the BP by 15% during the first 24 h after the onset of stroke	IV Nicardipine as indicated above
Intracerebral Hemorrhage (ICH)	SBP ≥180 mm Hg	<180 mm Hg Careful SBP lowering, avoiding reductions ≥60 mm Hg in 1 h Do not lower the BP acutely to <140 mm Hg	First choice: IV Nicardipine Second choice: IV labetalol
Secondary prevention Adults with history of stroke	140/90 mm Hg	≤ 130/80 mm Hg	First line: RAS blockers (ACE‐Inh, ARB), CCBs and thiazide diuretics