Background:The influence of blood pressure (BP) lowering on intracerebral hemorrhage (ICH) patients is unclear.To assess the safety and efficacy of aggressive antihypertensive therapies in acute ICH patients,we carried out a systematic review and meta-analysis.Methods:PubMed,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and VIP database up to July 2014 were searched.High-quality randomized controlled trials were included.Low-quality trials were excluded.Serious adverse events were defined as the primary outcome.The secondary outcomes were hematoma enlargement (HE) at 24 h after onset,mortality,and favorable clinical outcome at 90 days.Results:Four high-quality trials involving a total of 1427 patients met the inclusion criteria and were analyzed.Odds ratios (ORs) of primary outcome was 0.96 (95％ confidence interval [CI]:0.82-1.13,P =0.61).ORs of HE at 24 h after onset,mortality and favorable clinical outcome at 90 days were 0.91 (95％ CI:0.72-1.17,P =0.47),0.97 (95％ CI:0.79-1.20,P =0.81),1.13 (95％ CI:0.98-1.30,P =0.09) respectively.Conclusions:Aggressive BP management policies are safe and might have a potency of reducing HE and improving clinical outcome.