Questions on whether high blood pressure should be lowered, by how much, and for how long in patients with large vessel occlusion after endovascular therapy remain unresolved in the management of acute stroke. Observational data indicate that haemorrhagic transformation occurs in up to 46% of patients, with variable contributions to functional outcome.1 The association of high blood pressure with increased risk of intraparen-chymal haemorrhage after reperfusion favours the use of lower blood pressures targets (systolic blood pressure goal of <140 mm Hg),2 although evidence comes from studies with differing inclusion criteria and definitions of haemorrhagic complications, modest differences in mean and maximum systolic blood pressure between good and poor outcome groups, and underpowered hypothesis-generating designs.
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