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[Treatment of the rise in arterial pressure during the acute phase of stroke. Recommendation of Catalan Societies of Arterial Hypertension and Neurology].

INTRODUCTION
Changes in arterial pressure (PA), especially arterial hypertension, are frequent during the acute phase of a stroke and the best therapeutic approach is controversial since although high blood pressure is associated with a poor prognosis, excessive or too rapid drop in blood pressure may also be associated with progression of the neurological deficit.


OBJECTIVE
To reach agreement as to the correct therapeutic approach when the PA is high during the acute phase of a stroke, based on the published data and experience of a group of experts from the Catalan Societies of Neurology and Hypertension.


METHODS
Review of the main recommendations published in the literature and discussion in joint study sessions.


RESULTS
During the acute phase of a stroke moderate increases in blood pressure should not be treated. Antihypertensive treatment is recommended when the PA figures are of maintained levels of more than 220 mmHg of systolic or 120 mmHg of diastolic pressure in ischemic stroke, and over 180 mmHg of systolic or 105 mmHg of diastolic pressure in hemorrhagic stroke.


CONCLUSIONS
Modifications of arterial pressure, especially of arterial hypertension, should be carefully treated during the acute phase of stroke, because of the risk of causing worsening of the neurological lesion. When treatment is indicated, it is best carried out in a Stroke Unite where this is possible.