What is the appropriate blood pressure reduction to prevent recurrent cerebral infarction (ischemic stroke)?

The latest data show that the recurrence rate of cerebral infarction (ischemic stroke) in China is as high as 17.7%. Hypertension is the most important risk factor for stroke, so controlling blood pressure is an important means to reduce the recurrence and death of cerebral infarction. For most patients with cerebral infarction, it is appropriate to control blood pressure below 140/90 mmHg, which can significantly reduce the recurrence of cerebral infarction. The latest Chinese Guidelines for Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack (2014 edition) recommend that: 1. Patients with ischemic stroke or TIA who have not received prior antihypertensive therapy should initiate antihypertensive therapy if their BP is ≥140/90 mmHg several days after the onset of the event (I, A); 2. For patients with BP <140/90 mmHg, the benefit of antihypertensive therapy is not clear (II. B); 3. Patients with ischemic stroke or TIA with a previous history of hypertension and long-term treatment with antihypertensive medications should reinitiate antihypertensive therapy a few days after the onset of the disease if there is no absolute contraindication (I, A); 4. For patients with ischemic stroke or TIA due to atherosclerotic stenosis of large intracranial arteries (stenosis rate of 70-99%), a reduction of blood pressure to less than 140/90 mmHg is recommended (II, B) . In patients with stroke or TIA due to hemodynamic causes, the rate and magnitude of blood pressure reduction should be weighed against the frontal tolerance and hemodynamic effects on the patient (IV, B) 5. The choice of antihypertensive drug type and dose and the target value of blood pressure reduction should be individualized, and the 3 factors, drug, stroke characteristics, and patient, should be considered comprehensively (II, B).