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Hypertension and stroke - evidence based medicine

Elevated blood pressure (BP) is one of the most important stroke risk factors and there is no doubt about efficacy of lowering hypertension in order to prevent stroke but it is still unclear how to treat elevated BP in acute onset of stroke. Hypertension is one of the most potent risk factors of first ever and recurrent stroke. Lowering of blood pressure has been known for years to reduce the risk of a first stroke. Blood pressure (BP) lowering for primary prevention ofstroke could be undertaken using a variety of therapeutic agents: beta blockers, ACEI, ARB, CA, diuretics etc. The choice of first line antihypertensive drug is still difficult. Recently it has been shown that BP reduction in acute phase of stroke has detrimental effects. Therefore BP reducing should wait until the acute phase of stroke has resolved. After that BP lowering should probably be introduced slowly. Treatment of elevated BP in acute stroke is probably one of rare major clinical conditions with such lack of _ reliable data and studies. Present results are controversial. There is yet no scientific reason nor clinically proven benefit from the decrease of (not markedly) elevated BP. Optimal treatment of elevated BP in aeute stroke has not yet been established.

Hypertension; prevention; stroke; treatement

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