Blood pressure management in acute stroke.

Hypertension is the major risk factor for stroke. When patients present with an acute stroke of ischemic or hemorrhagic type, and have elevated blood pressure, there is a dilemma concerning blood pressure reduction. If the blood pressure remains elevated, this may worsen arterial blood vessel wall injury and increase cerebral edema; however if blood pressure is reduced, this may reduce cerebral perfusion pressure and worsen neurological deficit. A review of the existing literature on this controversial issue is presented.