[Hypertension associated with cerebrovascular disease].

In hypertensive patients with cerebrovascular disease, subjects to be treated with antihypertensive drugs and the target level of blood pressure control are determined on the basis of clinical disease type, interval after onset, severity, age, and the use of antithrombotic drugs. According to the guideline of the Japanese Society of Hypertension 2014 (JSH2014), in the hyperacute and acute phases of cerebral infarction, for which thrombolytic therapy is not indicated, the target of blood pressure control should be 85-90% of the pretreatment value when systolic and diastolic blood pressures exceed 220 and 120 mmHg, respectively. In the hyperacute and acute phases of cerebral hemorrhage antihypertensive therapy should be indicated for patients with a systolic blood pressure of > 180 mmHg or a mean blood pressure of > 130 mmHg. The target blood pressure should be < 140/90 mmHg. In the chronic phase of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, the target blood pressure should be < 140/90 mmHg. In patients with lacunar infarction, those taking antithrombotic drugs, cerebral hemorrhage and subarachnoid hemorrhage, a lower level, < 130/80 mmHg should be targeted if possible. Oral antihypertensive drugs such as Ca channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics are recommended for patients with cerebrovascular disease.