Studies on relationship between blood pressure management and stroke in the China expert's consensus on symptomatic intracranial atherosclerotic stenosis

Blood pressure management of ischemic stroke has been a controversial clinical problem, and even different studies contradict each other. With the recent advent of some large randomized-controlled clinical trials studies such as Candesartan Acute Stroke Trial (SCAST) and China Antihypertensive Trial in Acute Ischemic Stroke (CATIS), the direction of the problem seems to be more and more clearer, but there still exists somewhat puzzling issues. This article elaborates some personal opinion on relationship between blood pressure management and stroke in China expert’s consensus on symptomatic intracranial atherosclerotic stenosis, and provides the corresponding interpretations on seemingly contradictory issues. Arterial intimal vulnerable lesion might play a role in the J-curve phenomenon which may exist in the blood pressure management of ischemic stroke. The effect of blood pressure on risk of stroke may therefore present a turning point. For patients with symptomatic intracranial atherosclerotic stenosis, the importance of vascular assessment, especially arterial intimal vulnerable lesion assessment should be paid more attention to, which should be of assistance of making the therapy strategy of blood pressure management, anti-atherogenic and antithrombotic for the patients with symptomatic intracranial atherosclerotic stenosis.