1. Blood Pressure Goals in Ischemic Stroke 急性缺血性中风的血压控制 from Uptodate 1. In patients who are eligible for thrombolytic therapy. Before lytic therapy is started, treatment is recommended so that SBP is ≤185 mmHg and DBP is ≤110 mmHg. 对于适用 TPA 溶栓治疗的患者，建议溶栓治疗前血压必须在 SBP<185, DBP<110 2. Should be stabilized and maintained at or below 180/105 mmHg for at least 24 hours after thrombolytic treatment. 溶栓治疗后至少在 24 小时内血压必须保持在 180/105 以下

2. Blood Pressure not be Treated Acutely Unless: 除非有下列几种情况不强调在缺血性中风的急性治疗高血压 1.Hypertension is extreme: SBP>220 mmHg or DBP>120 mmHg, OR 血压实在高： SBP>220, DBP>120 2. patient has active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre-eclampsia/eclampsia 患者伴发有其它疾病，比如：急性缺血性冠心病、心衰、夹层动脉瘤、高血压 脑病、急性肾衰，子痫前期或子痫； When Treatment is Indicated, Cautious Lowering of Blood Pressure by approximately 15% during the first 24 hours after stroke onset is suggested 若在急性期有治疗高血压的指征，那么在急性中风的最初 24 小时也只能小心地 把血压降低 15% Blood Pressure Control in Patient who are not Treated with Thrombolytic Therapy （对于不适用 TPA 溶栓治疗的患者血压控制）

3. If acute antihypertensive therapy is needed, intravenous agents are generally used. Current guidelines note that vasopressors may be used to improve cerebral blood flow in rare cases when systemic hypotension is producing neurologic impairment, with close neurologic and cardiac monitoring. At present, drug-induced hypertension is not recommended for the treatment of most patients with ischemic stroke outside the setting of a clinical trial. Choice of antihypertensive agent — In the acute phase of stroke, there is no clear evidence to support the use of any specific antihypertensive agent to achieve recommended blood pressure goals. Nevertheless, reversible and titratable intravenous agents are best suited for precise blood pressure lowering. Consensus guidelines suggest intravenous labetalol and nicardipine as first-line antihypertensive agents if pharmacologic therapy is necessary in the acute phase, since they allow rapid and safe titration to the goal blood pressure.labetalol nicardipine Intravenous nitroprusside should be considered second-line therapy since it carries added theoretical risks of increasing intracranial pressure or affecting platelet function, but in fact it is often needed. Medications likely to cause a prolonged or precipitous decline in blood pressure (eg, rapid-acting formulations of nifedipine) should be avoided. In addition, their use is associated with an increased risk of stroke, particularly in older adult patients.nitroprussidenifedipine Blood Pressure Control in Patient who are not Treated with Thrombolytic Therapy