Management of arterial blood pressure in acute ischemic and hemorrhagic stroke.

It is essential to control arterial blood pressure (BP) in both hemorrhagic and ischemic stroke patients to decrease morbidity following an acute event and decrease the long-term risk of stroke recurrence. Pathophysiology of BP control is dependent on understanding key relationships of cerebral blood flow and cerebral perfusion pressure. In the long term, hypertensive control decreases the rate of incident and recurrent hemorrhagic and ischemic stroke. In the acute setting, neither when to start antihypertensive medication nor the optimal BP target goals for short- and long-term control are well defined. There are several different drug classes available for BP control, with considerable debate as to which drugs are preferred for stroke patients. Medication selection and target BP depend on individual patient characteristics, including type of stroke, medical comorbidities, and timing of interventions in the context of the acute or postacute phases of stroke. Copyright 2010 Elsevier Inc. All rights reserved.