III: No Benefit B-R Recommendation unchanged from 2018 Cholesterol Guidelines. 6.9. Institution of Antihypertensive Medications 6.9. Institution of Antihypertensive Medications COR LOE New, Revised, or Unchanged Starting or restarting antihypertensive therapy during hospitalization in patients with BP >140/90 mmHg who are neurologically stable is safe and is reasonable to improve long-term BP control unless contraindicated. IIa B-R New recommendation. Starting or restarting antihypertensive medications has been shown to be associated with improved control of the BP after discharge in 2 trials.247,248 Therefore, it is reasonable to start or restart antihypertensive medications in the hospital when the patient remains hypertensive and is neurologically stable. Studies evaluating this question included only patients with previous diagnosis of hypertension247 or enrolled mostly patients with previous hypertension.248 However, because hypertension is not uncommonly first diagnosed during the hospitalization for stroke, it is reasonable to apply this recommendation also to patients without preexistent hypertension. See Table LVI in online Data Supplement 1. 6.10. Smoking Cessation Intervention 6.10. Smoking Cessation Intervention COR LOE New, Revised, or Unchanged Smokers with AIS should receive in-hospital initiation of high-intensity behavioral interventions to promote smoking cessation. I A New recommendation. For smokers with an AIS, who receive in-hospital initiation of high-intensity behavioral interventions to promote smoking cessation, nicotine replacement therapy is recommended. I A New recommendation. A 2012 meta-analysis by the Cochrane group indicates that high-intensity behavioral interventions that begin during an index hospitalization and include at least 1 month of supportive contact after discharge increased smoking cessation rates after discharge (RR, 1.37 [95% CI, 1.27 1.48]; 25 trials). The estimate of the effect for each level of intervention intensity among patients with a cardiovascular diagnosis was very similar (RR, 1.42 [95% CI, 1.29 1.56]). 