Focused Update on Vascular Risk and Secondary Prevention in Survivors of Intracerebral Hemorrhage

ntracerebral hemorrhage (ICH) is the most disabling and deadly stroke subtype globally.However, an improved understanding of the natural history of ICH, coupled with advances in neurocritical and stroke systems of care, have led to the possibility of higher rates of survival during the index hospitalization.Stroke caregivers, families, and patients now reckon with identifying and successfully implementing strategies for secondary prevention.Many of the clinical and scientific questions in recent years focus on the interplay between thrombosis and recurrent bleeding.ICH survivors and the stroke community struggle with determining these competing risks, applying available therapies, and communicating decision making in both domains.This Focused Updates summarizes the current knowledge of cardiovascular events after ICH, the clinical management of blood pressure, antithrombotics, and lipid-lowering medications.Surviving an ICH is the first step toward converting a potentially devasting acute condition into a disease of chronic management.Identifying and implementing strategies that optimize chronic disease management is the next.