Blood pressure reduction should be gradual in the hospital setting, targeting approximately 10-15% per day. Overly aggressive lowering (below 120/80) may paradoxically increase recurrent stroke risk. For atherosclerotic stroke or TIA, aim for at least 50% LDL reduction or an LDL level below 70 mg/dL. High-dose statins reduce relative recurrent stroke risk by approximately 16%; each 40 mg/dL LDL reduction yields roughly 20% relative risk reduction.

Hypertension is the single most important modifiable stroke risk factor.Antihypertensive therapy reduces relative recurrent stroke risk by approximately 25%, regardless of baseline hypertension status.Stroke risk increases linearly with blood pressure; even modest reductions are beneficial.Overly aggressive BP lowering (below 120/80) may paradoxically increase recurrent stroke risk.Gradual BP reduction of 10-15% per day is recommended in the hospital setting.ACE inhibitors and diuretics have the strongest stroke-specific evidence, but the magnitude of reduction matters most.High-dose statins reduce relative recurrent stroke risk by approximately 16%; each 40 mg/dL LDL drop yields roughly 20% relative risk reduction.LDL target for atherosclerotic stroke or TIA: at least 50% reduction or below 70 mg/dL.