as well as systematic re- views and meta-analyses,S9.4.2-6 S9.4.2-8 indicate that antihy- pertensive agents reduce BP during the acute phase of an ischemic stroke but do not confer benefit with regard to short- and long-term dependency and mortality rate. One RCT did not demonstrate a benefit of continuing pre- stroke antihypertensive drugs during the first few days after an acute stroke, but it was substantially underpow- ered to answer the question.S9.4.2-4 9.4.3. Secondary Stroke Prevention Recommendations for Treatment of Hypertension for Secondary Stroke Prevention References that support recommendations are summarized in Online Data Supplements 43 and 44. COR LOE Recommendations I A 1. Adults with previously treated hypertension who experience a stroke or transient ischemic attack (TIA) should be restarted on antihypertensive treatment after the first few days of the index event to reduce the risk of recurrent stroke and other vascular I A 2. For adults who experience a stroke or TIA, treatment with a thiazide diuretic, ACE inhibitor, or ARB, or combination treatment consisting of a thiazide diuretic plus ACE inhibitor, is I B-R 3. Adults not previously treated for hypertension who experience a stroke or TIA and have an established BP of 140/90 mm Hg or higher should be prescribed antihypertensive treatment a few days after the index event to reduce the risk of recurrent stroke and other vascular I B-NR 4. For adults who experience a stroke or TIA, selection of specific drugs should be individualized on the basis of patient comorbidities and agent pharmacological IIb B-R 5. For adults who experience a stroke or TIA, a BP goal of less than 130/80 mm Hg may be IIb B-R 6. For adults with a lacunar stroke, a target SBP goal of less than 130 mm Hg may be IIb C-LD 7. 