When acute ischaemic stroke occurs alongside markedly elevated blood pressure — and reperfusion treatment is not being given — blood pressure management requires a specific, carefully calibrated approach. This protocol covers that scenario.
Acute ischaemic stroke, not receiving reperfusion treatment, presenting with BP ≥220/110 mmHg. The very high blood pressure level and the absence of reperfusion therapy together define the management context.
The approach centres on careful, controlled blood pressure lowering initiated in the acute stroke period. The pace and degree of reduction are both tightly defined — overly aggressive lowering risks compromising cerebral perfusion. The complete regimen, sequencing, and monitoring guidance are in the full structured protocol.
Achieve a defined proportional reduction in blood pressure within the first 24 hours of stroke onset — without overshooting. The exact target and titration guidance are in the full protocol.
DOI: 10.1093/eurheartj/ehae178