How should we manage acute hypertension in stroke? Here comes CHIPPS!

Current guidelines for ischaemic stroke stroke do not recommend emergency anti hypertensive therapy until SB 220 or DB 120 unless TPA is given. The guideline for hemorrhagic stroke allow a moderately more aggressive approach to blood pressure lowering depending on the clinician’s estimate or the actual measurement of intracranial pressure.
Results from a small study called CHIPPS presented at the American Stroke Association's (ASA's) International Stroke Conference 2008 demonstrated that immediate antihypertensive treatment targeted to a systolic blood pressure of 145 to 155 mm Hg or a drop in systolic blood pressure of 15 mm resulted in improved stroke outcomes at 3 months.
This small study should not change clinical practice and should be considered preliminary. Moreover, the study population was a mixture of patients with hemorrhagic stroke and ischemic stroke, limiting its applicability to either subgroup.