[Blood pressure treatment in the acute stage of stroke]

The results of previous studies on blood pressure in acute stroke therapy allow a few generally valid therapeutic recommendations. Efforts should be made to achieve a constant blood pressure level without major fluctuations. An antihypertensive therapy in the acute stage of stroke should be initiated only at highly elevated values. High blood pressure levels can be tolerated in patients with ischemic stroke unless thrombolytic comes into consideration. Should this be desired, the blood pressure must be quickly lowered to a target range of at least < 180 mmHg. In the case of intracerebral hemorrhage a blood pressure reduction appears to be beneficial. The ESO recommends a reduction to < 140 mmHg systolic within one hour, according to recommendations of the ESH and the EUSI but not more than 20 %.