Inclusion Criteria- Age ≥18 years
- Acute primary ICH demonstrated with CT scan, within 6 h of symptom onset.
- Two systolic BP measurements ≥180 mmHg recorded >2 min apart to qualify for enrolment.
- Onset ≤ 24 h prior to randomization
Exclusion Criteria- Contraindication to BP reduction i.e., severe arterial stenosis or high-grade stenotic valvular heart disease
- Indication for urgent BP reduction i.e., hypertensive encephalopathy, or aortic dissection
- Definite evidence that the ICH is secondary to underlying cerebral or vascular pathology, i.e., AVM, aneurysm, tumour, trauma, vasculitis, or hemorrhagic transformation of an ischemic infarct
- Previous ischemic stroke within 90 days of current event NB: Prior ICH is not an exclusion criterion
- Patients with suspected secondary cause of ICH.
- Planned surgical resection of hematoma NB: Extraventricular Drain placement is not an exclusion criterion
- Contraindication to CT perfusion imaging (i.e. contrast allergy, metformin use or Creatinine >160 μmol/l)
- Patients with pre-existing disability and dependence (defined as a pre-morbid modified Rankin Scale score ≥3) will be excluded
- Patients with life expectancy <6 months due to pre-morbid conditions/terminal illness
- Patients with known definite contraindications to MRI (pacemaker, ferrous metallic foreign body)