Aims: To evaluate the effect of the drugs in terms of ambulatory BP (ABPM) and clinical reductions, as well as analysing their effect on some variables such as BP morning surge, trough-peak ratio and smoothness index, which have been shown to be predictive of cardiovascular and cerebrovascular risk. Patients and Methods: 140 patients who had an ischemic stroke with hypertension during the acute phase (in first 7 days) were evaluated for inclusion. Inclusion criteria were the following: a mean 24 hours ambulatory BP >130/80 mmHg (measured on the first day after the diagnosis of stroke) and if the patients who had a clinical BP ≥ 180/105mm Hg were taken the antihypertensive drugs (lercanidipine or amlodipine) after taking the machine of ABPM. The patients with clinical BP <180/105 mmHg were followed for a 6 days observation periodand taking the antihypertensive drugs (lercanidipine or amlodipine) at seventh day. We evaluated drug efficacy by using clinical BP, 24h ambulatory BP, average day and night BP, the rate of responder and normalized patients; trough/peak ratio (T/P) and smoothness index (SI); and early morning BP surge rate (MBPS). All data were analysed with SPSS 20 software.We used χ2 test to compare 2 rates and  t-test to compare 2 means value. Statistical significant level was usedwith p value: 0.05, 0.01, 0.001. Results: Trough/peak ratio and smoothness index of lercanidipine, in patients with ischemic stroke and hypertension, after the 4-week treatment rise in a statistically significant way, although they remain lower than the readings found in the group treated with amlodipine (T/P = 0.61 for SBP and = 0.52 for DBP versus 0.75 for SBP and 0.73 for DBP; SI = 0.79 for SBP and = 0.57 for DBP versus 1.22 for SBP and 1.0 for DBP). Lercanidipine may be associated with a lower incidence of peripheral oedema than are older dihydropyridine CCBs.  Our study showed that the rate of patients suffering adverse events in the amlodipine treated group was significantly higher compared to the lercanidipine treated group (p = 0.0379 and p = 0.0253 respectively). Conclusion: This study shows that lercanidipine is an effective drug in ambulatory 24h and clinical BP reduction. The efficacy shown by lercanidipine is similar to amlodipine’s and showing a lower rate of adverse events when compared to amlodipine. It is concluded that lercanidipine can be an adequate choice when treating hypertensive patients with stroke.