The BP level that should be maintained in patients with AIS to ensure that the best outcome is not known. Some observational studies show an association between worse outcomes and lower BPs, whereas others do not.116 123 No studies address the treatment of low BP in patients with stroke. In a systematic analysis of 12 studies comparing colloids with crystalloids, the odds of death or dependence were similar. Clinically important benefits or harms could not be excluded. There are no data to guide volume and duration of parenteral fluid delivery.124 No studies have compared different isotonic fluids. See Table XXIX in online Data Supplement 1. In patients with AIS, early treatment of hypertension is indicated when required by comorbid conditions (eg, concomitant acute coronary event, acute heart failure, aortic dissection, postfibrinolysis sICH, or preeclampsia/ eclampsia). I C-EO New recommendation. Patients with AIS can present with severe acute comorbidities that demand emergency BP reduction to prevent serious complications. However, it is important to keep in mind that excessive BP lowering can sometimes worsen cerebral Ideal management in these situations should be individualized, but in general, initial BP reduction by 15% is a reasonable goal. There are no data to show that one strategy to lower BP is better than another after AIS. The medications and doses in Table 5 are all reasonable options. In patients with BP 220/120 mmHg who did not receive IV alteplase or mechanical thrombectomy and have no comorbid conditions requiring urgent antihypertensive treatment, the benefit of initiating or reinitiating treatment of hypertension within the first 48 to 72 hours is uncertain. It might be reasonable to lower BP by 15% during the first 24 hours after onset of stroke. IIb C-EO New recommendation. 