What are the AHA recommendations for management of hypertension in patients with transient ischemic attack (TIA)?

Updated: Dec 03, 2018
  • Author: Ashish Nanda, MD; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Patients may be significantly hypertensive. Unless there is specific concern for end-organ damage from a hypertensive emergency, blood pressure should be managed conservatively while ischemic stroke is being ruled out.

For acute ischemic stroke, the AHA recommends initiating antihypertensive therapy only if blood pressure is higher than 220/120 mm Hg or if mean arterial pressure exceeds 130 mm Hg. Unless there is a comorbid cardiac or other condition that necessitates reduction of blood pressure, allowing the patient’s blood pressure to autoregulate at a higher level (during the acute phase) may help maximize cerebral perfusion pressure. [44]


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