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Management of Chronic Hypertension Following Intracerebral Hemorrhage

Van Matre, Edward T. PharmD, MS, BCCCP; Cook, Aaron M. PharmD, BCPS, BCCCP; Shah, Samarth P. PharmD, BCPS; Rydz, Alexandria C. PharmD; Smetana, Keaton S. PharmD, BCCCP

doi: 10.1097/CNQ.0000000000000248
Original Articles

Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Clinical evidence is relatively lacking for clinicians to understand the extent of blood pressure lowering and the optimal agents to use in this setting. Limited data exist describing the long-term management of hypertension in patients after cerebrovascular events. This review provides nurses with a summary of the available literature on long-term blood pressure management to minimize the risk of secondary ICH and ischemic stroke. It focuses on oral antihypertensive medications available in the United States that may be utilized to manage chronic hypertension immediately after the postacute phase of care to lower blood pressure and to improve long-term outcomes.

Department of Clinical Pharmacy and Translational Science, University of Tennessee College of Pharmacy, Memphis (Dr Van Matre); Pharmacy Services, University of Kentucky HealthCare, Lexington (Dr Cook); Department of Pharmacy, Methodist University Hospital, Memphis, Tennessee (Dr Shah); and Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus (Drs Rydz and Smetana).

Correspondence: Keaton S. Smetana, PharmD, BCCCP, The Ohio State University Wexner Medical Center, 410 W. 10th Ave, Doan Hall Room 368, Columbus, OH 43210 (

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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