Blood Pressure Control: Which Patients May Benefit Most From Specific Strategies?

How should clinicians think about hypertension in 2026?

In this episode of Voice of Stroke, we explore recent evidence addressing one of the most important questions in vascular prevention: not simply whether to lower blood pressure, but which treatments work best, who should be treated, and how hypertension-related vascular disease may influence stroke mechanisms and secondary prevention.

This episode discusses: 

• Meta-analyses evaluating the efficacy and tolerability of antihypertensive drugs and combinations
• Blood pressure lowering in isolated diastolic hypertension
• An exploratory analysis of the ARCADIA trial examining high-risk hypertension features and recurrent stroke prevention

Featuring discussion of recent studies published in The Lancet, JAMA, European Heart Journal and JAMA Neurology.

Written by Voice of Stroke Podcast Editor-In-Chief Linxin Li and Co-Editor Maria Magdalena Gabriel.

Read the full transcript here.

References

• Ridha M et al. Hypertension With High-Risk Features in Cryptogenic Stroke: An Exploratory Analysis of the ARCADIA Randomized Clinical Trial. JAMA Neurology. 2026.
• Bidel Z et al. Blood pressure lowering in isolated diastolic hypertension and cardiovascular risk: an individual patient data meta-analysis. European Heart Journal. 2026.
• Wang N et al. Blood pressure-lowering efficacy of antihypertensive drugs and their combinations. The Lancet. 2025.
• Wang N et al. Adverse Effects and Treatment Discontinuation of Blood Pressure-Lowering Drugs and Combinations. JAMA. 2026.
• Blood Pressure Treatment Efficacy Calculator: https://www.bpmodel.org/blood-pressure-treatment-efficacy-calculator/