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Objectives To compared the effect of early antihypertensive treatment started within 24-48 h of stroke onset versus delaying treatment until day eight on reducing dependency or death. Design Multicentre, randomised, open label trial. Setting 106 hospitals in China between 13 June 2018 and 10 July 2022. Participants 4810 patients (≥40 years) were enrolled with acute ischaemic stroke within 24-48 h of symptom onset and elevated systolic blood pressure between 140 mm Hg and <220 mm Hg. Interventions Patients were randomly assigned to receive antihypertensive treatment immediately after randomisation (aimed at reducing systolic blood pressure by 10%-20% within the first 24 h and a mean blood pressure <140/90 mm Hg within seven days) or to discontinue antihypertensive medications for seven days if they were taking them, and then receive treatment on day 8 (aimed at achieving mean blood pressure <140/90 mm Hg). Main outcome measures The primary outcome was the combination of

Monte carloShenzhen kangzhe pharmaceutical coNational institutes of healthData coordinating centerInstitutional review board of tulane universityTechnology of chinaTechnology commissionSoochow universityMinistry of scienceTulane universityChinese stroke associationSteering committeeCapital medical universityData coordinating center at beijing tiantan hospitalInterventions patientsConclusions among