Management of hypertension in acute stroke

Hypertension is commonly seen in the setting of an acute stroke. Although hypertension is the most important modifiable risk factor for both ischemic and hemorrhagic stroke, the immediate management of elevated blood pressure in this setting is controversial. Questions remain to be definitively answered, such as when to start lowering blood pressure, by how much to lower pressure, which pharmaceutical agents to use and whether to continue or stop previous antihypertensive medications. Recently, pilot studies have been initiated in an attempt to answer these questions and will hopefully lay the foundation for larger definitive studies.