Secondary analysis found that statin treatment, increasing age, and having ICH as the qualifying stroke for study enrollment were factors associated with later ICH However, a meta-analysis of 31 randomized controlled trials that included 91 588 statin-treated patients found no significant association between statin use and ICH all-cause mortality were significantly reduced with statin A Markov analysis evaluating the risks and ben- efits of statin therapy in patients with prior ICH concluded that if statin use does increase the risk of ICH, avoidance of statins should be considered in patients with ICH, particu- larly those with lobar ICH.311 Concordant with these con- clusions, statin use and age were independently associated with the presence and number of microbleeds, especially in cortical locations, in ICH patients.313 In contrast, continued statin use after ICH was associated with early neurologi- cal improvement and reduced 6-month mortality in a small There are no data on whether the reported propensity for ICH with statin use is dose depen- dent. It remains unclear whether statins should be continued or discontinued in ICH patients. Prevention of Recurrent ICH: Recommendations When stratifying a patient s risk for recurrent ICH may affect management decisions, it is reasonable to consider the following risk factors for ICH recur- rence: (1) lobar location of the initial ICH; (2) older age; (3) presence and number of microbleeds on gra- dient echo MRI; (4) ongoing anticoagulation; and (5) presence of apolipoprotein E 2 or 4 alleles (Class IIa; Level of Evidence B). (Revised from the previous guideline) BP should be controlled in all ICH patients (Class I; Level of Evidence A). (Revised from the previ- ous guideline) Measures to control BP should begin immediately after ICH onset (Class I; Level of Evidence A). 