Hypertension Management and Secondary Stroke Prevention

In “Hypertension Management and Secondary Stroke Prevention,” Greg Albers, MD,

Eva Mistry, MD and James Siegler, MD, delve into the following critical topic:

1. Discuss importance of hypertension management for secondary stroke prevention.

Hypertension is emphasized as the single most important modifiable risk factor for both ischemic and hemorrhagic stroke, yet it remains poorly controlled and requires sustained, coordinated management with primary care. Clinicians now generally aim for blood pressure targets at or below 130/80 mmHg, and when safe often in the 120s systolic, recognizing that “lower is better” for most patients while avoiding hypotension in older or frail individuals. Because high blood pressure and other vascular risks are largely symptomless and feel intangible to patients, education, addressing misconceptions (e.g., about statin side effects), and making lifestyle changes feel achievable are all critical. Newer tools such as polypills, home monitoring apps, and updated hypertension guidelines are helping clinicians initiate and maintain effective therapy, including in patients who are treatment‑naïve.

Our next episode, “Factor XI Inhibitors for Stroke Prevention,” further explores secondary stroke prevention.