Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED)

Inclusion Criteria

• •Adult (age ≥18 years)
• •A clinical diagnosis of acute ischaemic stroke confirmed by brain imaging
• •Able to receive treatment within 4.5 hours after the definite time of onset of symptoms
• •Have a systolic BP ≤185 mmHg
• •Provide informed consent (or via an appropriate proxy, according to local requirements)
• •Specific criteria for arm \[A\] of low-dose vs standard-dose rtPA (Recruitment completed in August 2015.):
• •Able to receive either low-dose or standard-dose rtPA
• •Specific criteria for arm \[B\] of intensive BP lowering vs guideline recommended BP control
• •Patient will or has received thrombolysis treatment with rtPA, either randomised dose within the trial or physician decided dose rtPA outside of the trial
• •Sustained elevated systolic BP level, defined as 2 readings ≥ 150 mmHg
• •Able to commence intensive BP lowering treatment within 6 hours of stroke onset
• •Able to receive either immediate intensive BP lowering or conservative BP management