38
Hypertension in Patients With Comorbidities
Figure 8. Management of Hypertension in Patients With
Acute Ischemic Stroke
Acute (<72 h from symptom onset)
ischemic stroke and elevated BP
Patient
qualifies for
IV thrombolysis
therapy
Lower SBP to <185 mm
Hg and DBP <110 mm
Hg before initiation of IV
thrombolysis
(Class I)
Colors correspond to Class of Recommendation on page 56–57.
Lower BP 15%
during first
24 h
(Class IIb)
YES NO
BP
≤220/110 mm
Hg
For preexisting
hypertension, reinitiate
antithypertensive drugs
after neurological stability
(Class IIa)
BP
>220/110 mm
Hg
Initiating or reinitiating
treatment of hypertension
within the first 48–72 hours
after an acute ischemic
stroke is ineffective to
preven death or dependency
(Class III: No Benefit)
And
Maintain BP <180/105 mm
Hg for first 24 h after IV
thrombosis
(Class I)
