See Table XXVIII in online Data Supplement 1. 3.2. Blood Pressure 3.2. Blood Pressure COR LOE New, Revised, or Unchanged Hypotension and hypovolemia should be corrected to maintain systemic perfusion levels necessary to support organ function. I C-EO New recommendation. The blood pressure (BP) level that should be maintained in patients with AIS to ensure the best outcome is not known. Some observational studies show an association between worse outcomes and lower BPs, whereas others have No studies have addressed the treatment of low BP in patients with stroke. In a systematic analysis of 12 studies comparing the use of IV colloids and 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 No studies have compared different isotonic fluids. See Table XXIX in online Data Supplement 1. Patients who have elevated BP and are otherwise eligible for treatment with IV alteplase should have their BP carefully lowered so that their SBP is <185 mmHg and their diastolic BP is <110 mmHg before IV fibrinolytic therapy is initiated. I B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. The RCTs of IV alteplase required the BP to be <185 mmHg systolic and <110 mmHg diastolic before treatment and <180/105 mmHg for the first 24 hours after treatment. Options to treat arterial hypertension in patients with AIS who are candidates for immediate reperfusion therapy are given in Table 5. 