Abstract: 【Objective】 To explore the difference of blood pressure course and outcome in acute ischemic stroke subtypes according to TOAST criteria. 【Methods】 Thirty-six patients diagnosed ischemic stroke in the first 24h after onset were performed 72h consecutively ambulatory blood pressure motoring. Those who used antihypertensive agents were excluded. There were 11 patients in LAA subtype

3 patients in CE subtype

11 patients in SAO subtype

3 patients in SOD subtype and 8 patients in SUD subtype. BP values included SBP

DBP

P and nocturnal BP drop rate. Outcomes were neurologic deterioration and independence at 3 months. 【Results】 In the first three days after stroke onset

the courses of average systolic pressure

diastolic pressure and pulse were absolutely different in TOAST subtypes (P < 0.001). The average SBP and DBP of LAA subtype grew unceasingly

while the BP values of other subtypes were declining. CE subtype got the lowest average SBP and DBP and the highest P. In those three days

all subtype had a decreased nocturnal blood pressure dipping and an increased ratio of nocturnal hypertension

especially the diastolic pressure and the large-artery atherosclerosis subtype.For those who had a higher average systolic pressure on Day 3 than Day 1

more patients had poor outcome in large-artery atherosclerosis subtype

while more patients had favorable outcome in small-artery occlusion subtype. 【Conclusion】 The blood pressure course and outcome are totally different in acute ischemic stroke subtypes according to TOAST criteria. Ambulatory blood pressure motoring may lead to more appropriate targeting of antihypertensive treatment for ischemic stroke patients.