Optimal Blood Pressure for the prevenTIon of Major vAscuLar Events in Stroke Patients

Prior treatment

• Conditions that, at the investigators' discretion, limit the patient's participation in the study, including but not limited to the following:
  • Recent history of alcohol and illicit drug abuse.
  • Psychiatric comorbidities (severe depression, schizophrenia, psychosis, etc.).
  • History of poor drug adherence and no attendance at consultations.
  • Planning to change of address in the next four years.
  • Planning to be absent from home city for more than three months in the next year.
  • Residing in the same residence of another patient previously included in this study.

Other illness

• Secondary hypertension.
• Class IV Canadian Cardiovascular Society (CCS) Resting Angina.
• Acute coronary syndrome in the last six months

Lab values

• Severe renal dysfunction with GFR \< 20 mL/min/1.73m2 calculated by the CKD-EPI equation
• Symptomatic heart failure - Class IV New York Heart Association (NYHA) or ejection fraction \<35% on Doppler echocardiography.

Other

• Severe disability after the event that qualified the patient for the study, defined as a modified Rankin (mRankin) scale equal to or greater than 4.
• Being part of another clinical trial involving interventions for cardiovascular prevention.
• Body mass index \> 45 kg/m2.
• Pregnancy or Breastfeeding.
• Refusal to consent.

• History of ischemic stroke or transient ischemic attack (TIA), considered clinically stable in the 48 hours prior to inclusion in the study. (they will be classified into a recent stroke \<120 days or chronic when\> 120 days), AND
• Systolic Blood Pressure (SBP) between 130 and 180 mmHg:
  • 130 -180 and use of up to one antihypertensive drug;
  • 130-170 and use of up to two drugs;
  • 130-160 and use of up to three drugs;
  • 130-150 and use of up to four drugs. AND