The optimal timing for initiating BP lowering after ICH to prevent recurrence is unknown. In INTERACT2, rapid reduction of SBP to <140 mmHg within a few hours was safe, which indicates that such treatment can be safely initiated as soon as possible after ICH onset.134 Management of Antithrombotic Drugs The rising use of anticoagulant agents in an aging population is associated with increased risk of ICH and its recurrence.292 There is a marked paucity of prospective population-based data on the risk of ICH recurrence and mortality after reini- tiation of warfarin. In a cohort of 284 consecutive patients with warfarin-related ICH in the Registry of the Canadian Stroke Network, mortality rates were lower in those who restarted warfarin in the hospital: 31.9% versus 54.4% at 30 the rates of bleeding events were not increased.293 In a ret- rospective cohort study of 2869 ICH patients, of whom 234 had warfarin-associated ICH, the HR for recurrent ICH with resumption of warfarin was 5.6 (95% CI, 1.8 17.2) during a In another study of 48 patients with warfarin-associated ICH, of 23 patients who began taking warfarin again, 1 had a recurrent ICH and 2 subsequently had traumatic intracranial hemorrhage, whereas none who did not restart warfarin had recurrent intracranial bleeding. 