39
Secondary Stroke Prevention
COR LOE
Recommendations
I A Adults with previously treated hypertension who experience a
stroke or transient ischemic attack (TIA) should be restarted on
antihypertensive treatment aer the first few days of the index
event to reduce the risk of recurrent stroke and other vascular
events.
I A For adults who experience a stroke or TIA, treatment with
a thiazide diuretic, ACE inhibitor, or ARB, or combination
treatment consisting of a thiazide diuretic plus ACE inhibitor, is
useful.
I B-R Adults not previously treated for hypertension who experience
a stroke or TIA and have an established BP of 140/90 mm Hg
or higher should be prescribed antihypertensive treatment a few
days aer the index event to reduce the risk of recurrent stroke
and other vascular events.
I B-NR For adults who experience a stroke or TIA, selection of
specific drugs should be individualized on the basis of patient
comorbidities and agent pharmacological class.
IIb B-R For adults who experience a stroke or TIA, a BP goal of less than
130/80mm Hg may be reasonable.
IIb B-R For adults with a lacunar stroke, a target SBP goal of less than
130 mm Hg may be reasonable.
IIb C-LD In adults previously untreated for hypertension who experience
an ischemic stroke or TIA and have a SBP less than 140 mm
Hg and a DBP less than 90 mm Hg, the usefulness of initiating
antihypertensive treatment is not well established.
