Because the speed and degree of BP reduction will vary according to the agent and method of deliv- ery (bolus versus infusion) and clinical features, the choice of agent should take into account the practicability, pharmaco- logical profile, potential side effects, and cost. BP: Recommendations For ICH patients presenting with SBP between 150 and 220 mmHg and without contraindication to acute BP treatment, acute lowering of SBP to 140 mmHg is safe (Class I; Level of Evidence A) and can be effective for improving functional outcome (Class IIa; Level of Evidence B). (Revised from the previous guideline) For ICH patients presenting with SBP >220 mmHg, it may be reasonable to consider aggressive reduc- tion of BP with a continuous intravenous infusion and frequent BP monitoring (Class IIb; Level of Evidence C). (New recommendation) Inpatient Management and Prevention of Secondary Brain Injury General Monitoring Patients with ICH are frequently medically and neurologically unstable, particularly within the first few days after onset. Care of ICH patients in a dedicated neuroscience intensive care unit is associated with a lower mortality rate.136 Many patients in the INTERACT2 study were cared for in a dedi- cated stroke unit rather than an intensive care unit.134 Frequent vital sign checks, neurological assessments, and continuous cardiopulmonary monitoring including a cycled automated BP cuff, electrocardiographic telemetry, and pulse oximetry probe should be standard. Continuous intra-arterial BP moni- toring should be considered in patients receiving intravenous vasoactive medications. 