When a patient has an acute cerebral infarction, about 70% of patients with acute cerebral infarction have elevated blood pressure in the acute phase, mainly due to pain, nausea and vomiting, increased intracranial pressure, confusion, anxiety, post-stroke stress, and the presence of hypertension before the disease. Is aggressive blood pressure lowering treatment needed at this time? Let’s take a look at the results of three important clinical trials: the INWEST study confirms that there may be no benefit to substantially lowering blood pressure in the acute phase of cerebral infarction, the SCAST study finds that there may be no benefit to moderately lowering blood pressure in the acute phase of cerebral infarction, and the VENTURE study finds that there may be no benefit to mildly lowering blood pressure in the acute phase of cerebral infarction. . Our latest guidelines for the diagnosis and treatment of acute ischemic stroke (2014 edition) state that patients with elevated blood pressure within 24 h of ischemic stroke should be managed with caution. Tension and anxiety, pain, nausea and vomiting, and increased intracranial pressure should be managed first. Patients with persistently elevated blood pressure, systolic blood pressure ≥ 200 mmHg or diastolic blood pressure ≥ 110 mmHg, or with severe cardiac insufficiency or aortic coarctation hypertensive encephalopathy, may be treated with antihypertensive therapy and closely monitored for blood pressure changes. Intravenous drugs such as labetalol and nicardipine can be used to avoid drugs that cause a sharp drop in blood pressure. If the condition is stable after stroke and blood pressure is persistently ≥140/90 mmHg with no contraindications, the use of antihypertensive drugs taken before the onset of the disease may be resumed or antihypertensive therapy may be initiated several days after the onset of the disease.