The Bottom Line: The effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain. This RCT concluded that bloodpressure reduction with antihypertensive medications, compared with the absence of hypertensive medication, did not reduce the likelihood of death and major disability at 14 days or hospital discharge.
Reference: He, Jiang, Zhang, Yonghong, Xu, Tan, Zhao, Qi, Wang, Dali, Chen, Chung-Shiuan, Tong, Weijun, Liu, Changjie, Xu, Tian, Ju, Zhong, Peng, Yanbo, Peng, Hao, Li, Qunwei, Geng, Deqin, Zhang, Jintao, Li, Dong, Zhang, Fengshan, Guo, Libing, Sun, Yingxian, Wang, Xuemei, and Cui, Yong. “Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients with Acute Ischemic Stroke: The CATIS Randomized Clinical Trial.” JAMA the Journal of the American Medical Association. 311.5 (2014): 479-89.
For Additional Reading: Gorelick, Philip B. “Should Blood Pressure be Lowered in Acute Ischemic Stroke? The CATIS Trial.” Journal of American Society of Hypertension 9.5 (2015):331-333.
Ivanov A, Mohamed A, Korniyenko A. “Permissive Hypertension In Acute Ischemic Stroke: Is It a Myth or Reality?” Journal of the American College of Cardiology. 65.10S (2015). doi:10.1016/S0735-1097(15)61344-4.