In 755 patients with acute stroke, blood pressure was followed throughout the hospital stay. The blood pressure showed a fast decline after admission. Patients with intracerebral hemorrhage had higher blood pressure levels and a slower blood decline than patients with other stroke diagnoses. Patients with a history of hypertension consistently had higher blood pressures than nonhypertensives throughout the acute phase. The blood pressure showed grossly the same course irrespective of the latency between the onset of stroke Symptoms and admission. Patients with severer neurological deficits or impaired consciousness had no higher blood pressures than the other patients. It is hypothesized that mental stress may play an important role for the high blood pressure levels often seen on hospital admission in stroke patients.