XI. Treatment of hypertension in association with stroke

Prevention and Treatment

Recommendations

  1. BP management in acute ischemic stroke (onset to 72 hours)
    1. For guidelines on BP management in acute ischemic stroke, refer to the current Canadian Stroke Best Practices recommendations (www.strokebestpractices. ca/recommendations).
  2. BP management after acute ischemic stroke
    1. Strong consideration should be given to the initiation of antihypertensive therapy after the acute phase of a stroke or transient ischemic attack (Grade A).
    2. After the acute phase of a stroke, BP-lowering treat-ment is recommended to a target of consistently < 140/90 mm Hg (Grade C).
    3. Treatment with an ACE inhibitor and thiazide/thiazide-like diuretic combination is preferred (Grade A).
    4. For patients with stroke, the use of an ACE inhibitor with an ARB is not recommended (Grade B).
  3. BP management in hemorrhagic stroke (onset to 72 hours)
    1. For guidelines on BP management in acute hemor-rhagic stroke, refer to the current Canadian Stroke Best Practices recommendations (www.strokebestpractices. ca/recommendations).