While modi able bleeding risk factors that can be changed or managed should clearly be addressed as part of a holistic approach to AF patient assessment and management, nonmodi able bleeding risks are important drivers of bleeding events when occurring synergistically with An approach to bleeding risk assessment soley based only on modi able bleeding risk factors is an inferior assessment strategy compared with use of a formal bleeding risk score.78-80 BP Control: Good control of BP is vital to reduce the risk of stroke and is essential to decrease the risk of bleeding on antithrombotic therapy; adherence to current guidelines on the management of hypertension should be followed. Anticoagulation Control: Among patients receiving VKA, maintenance of an international normalized ratio (INR) in the therapeutic range (2.0-3.0) is essential. The proportion of time spent in this range (TTR) should be at least 65% but the ultimate aim/target should be 100% (see Optimal INR Target Range section). The risk of bleeding increases when the INR exceeds 3.0, particularly for ICH risk when INR > 3.5.81-86 INR control can potentially be improved by more frequent monitoring and review of factors in uencing INR control (diet-, alcohol-, and drug-interactions). There is evidence that improving patient education about INR control,87 INR management by dedicated anticoagulation clinics with experienced personnel,88-90 and self-monitoring/self-management in selected can increase TTR. Increasing patient s awareness of the importance of OAC medication adherence and the potential bleeding risks associated with overdose are also essential to minimize bleeding complications. 