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The optimal timing of initiating blood pressure lowering in the acute phase after ischemic stroke is uncertain. Although a 2015 meta-analysis of 13 trials failed to show a benefit of antihypertensive treatment initiated within 3 days of symptom onset, an exploratory subgroup analysis of data from CATIS (Chinese Antihypertensive Trial in Acute Ischemic Stroke) suggested that blood pressure lowering initiated between 24 and 48 hours might have a benefit.
In this follow-up CATIS-2 trial, 4810 acute ischemic stroke patients aged 40 years or older, presenting at 106 hospitals in China within 24 to 48 hours after symptom onset with systolic blood pressure between 140 mm Hg and 220 mm Hg, were randomized to early or delayed blood-pressure lowering.…