ABSTRACT
Arterial hypertension is one of the most important modifiable risk factors for stroke. Several observational studies have revealed a positive and continuous association between blood pressure (BP) levels and stroke. Primary and secondary prevention clinical trials have demonstrated that BP reduction diminishes the risk of first-ever and recurrent stroke, respectively, independent of baseline BP levels. Based on pathophysiological facts and research findings, the management of post-stroke hypertension remains controversial since there are arguments against and in favour of BP lowering during the acute phase of stroke. The safety of intensive BP-lowering treatment in patients with acute haemorrhagic stroke was investigated by two pilot, prospective, randomized trials, which were used as feasibility studies allowing the designing of larger trials. During the acute phase of stroke, the optimal management of arterial hypertension remains an issue of longstanding debate and of little consensus, since the results of the observational studies are conflicting, and the findings of the randomized clinical trials are neutral.
