Hypertension is still one of the major risk factors for stroke. There are guidelines on best medical treatment against acute and chronic stages of stroke. In acute phase, aggressive antihypertensive treatment was shown to cause impairment of cerebral circulation, and even in chronic stage, J-curve phenomenon used to be one of the topics in recurrent stroke. Thereafter, modest approach to control blood pressure has been recommended, especially in case of atherothrombotic brain infarction. On the other hand, rather earlier smooth landing from acute stroke hospital to the convalescent and chronic rehabilitation hospital is generally accepted these days. The current status and future on hypertension therapy in acute as well as chronic stages will be discussed in this issue. Moreover, treatment against arrhythmia such as non-valvular atrial fibrillation and thrombotic as well as metabolic disorders is also important in this field; then, so-called pleiotherapy (an novel abbreviated terminology of pleiotropic therapy) is quite indispensable nowadays.