Blood Pressure Goals in Acute Stroke—How Low Do You Go?

  • Iryna Lobanova
  • Adnan I. Qureshi
Hypertension and Emergency Medicine (T Rainer and P Levy, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Hypertension and Emergency Medicine


Purpose of Review

Elevations in systolic blood pressure (BP) greater than 140 mmHg are reported in the majority (75%) of patients with acute ischemic stroke and in 80% of patients with acute intracerebral hemorrhages (ICH). This paper summarizes and updates the current knowledge regarding the proper management strategy for elevated BP in patients with acute stroke.

Recent Findings and Summary

Recent studies have generally showed a neutral effect of BP reduction on clinical outcomes among acute ischemic stroke patients. Thus, because of the lack of convincing evidence from clinical trials, aggressive BP reduction in patients presenting with acute ischemic stroke is currently not recommended. Although in patients treated with intravenous tissue plasminogen activator, guidelines are recommending BP < 180/105 mmHg but currently, the optimal BP management after reperfusion therapy still remains unclear. In acute ICH, the evidence from randomized clinical trials supports the immediate BP lowering targeting systolic BP to 140 mmHg, which is now recommended by guidelines.


Blood pressure Ischemic stroke Intracerebral hemorrhage 


Compliance with Ethics Guidelines

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Zeenat Qureshi Stroke InstituteSt. CloudUSA

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