There is insufficient evidence to recommend a lower limit of BP within the normal range for patients with prior stroke. Additional research is needed to determine the optimal timing for BP reduction after stroke205 ; therefore, these recommen- dations pertain to outpatient management of neurologi- cally stable patients. Recommendation-Specific Supportive Text 1. Diuretics, angiotensin-converting enzyme inhibi- tors, and angiotensin receptor blockers have dem- onstrated benefit in RCTs or systematic reviews of Although calcium channel blockers are recommended for the treatment of hyperten- sion, there are limited data on their efficacy for secondary stroke prevention. However, the use of calcium channel blockers is reasonable for patients with stroke who require additional medication 2. Data from 4 RCTs and recent meta-analyses sup- port a benefit of treating patients with prior stroke or TIA to achieve a goal BP of <130/80 mmHg. The RESPECT (Randomized Evaluation of Recurrent Stroke Comparing PFO Closure to Established Current Standard of Care Treatment),190 PAST-BP (Prevention After Stroke Blood Pressure),191 SPS3 (Secondary Prevention of Small Subcortical and PODCAST (Prevention of Decline in Cognition after Stroke Trial)193 RCTs all compared intensive control of BP (SBP targets ranging from <120 <130 mmHg) with standard BP control (SBP targets ranging from <140 <150 mmHg) in patients with prior cerebrovascular disease. These trials all reported nonsignificant tendencies toward lower recurrent stroke rates in the intensive treat- ment groups. However, a meta-analysis of these 4 trials showed a significant reduction in recurrent stroke risk with an intensive versus standard tar- get (RR, 0.78 [95% CI, 0.64 0.96]). An indepen- dent Cochrane analysis185 of SPS3, PAST-BP, and PODCAST (done before RESPECT publication) reported a trend toward benefit of intensive BP CLINICAL STATEMENTS AND GUIDELINES Kleindorfer targets (pooled RR for recurrent stroke, 0.80 [95% CI, 0.63 1.00]). 