Management of acute and recurrent stroke with control of blood pressure

Hypertension is the most important modifiable risk factor for stroke. (Gorelick, 2002; Pedelty and Gorelick, 2004) It is estimated that 25% or more of strokes may be attributable to hypertension. Because many patients with stroke have mild hypertension or prehypertension, we have shifted our focus and now think of stroke on a continuum of risk based on blood pressure (BP) level rather than on a threshold effect. (Elliott, 2007) Because high BP may not exist in isolation, a wider definition of hypertension has been proposed that also takes into account the absolute risk of cardiovascular events and associated metabolic factors or early disease markers. (Elliott, 2007)