ABSTRACT NUMBER: ESOC2026A1675 EFFECTS OF INTENSIVE BLOOD PRESSURE LOWERING ON DISABILITY AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH INTRACEREBRAL HEMORRHAGE: TRIDENT TRIAL

Abstract Background and aims Long-term disability and health-related quality of life (HRQol) after intracerebral hemorrhage (ICH) remain insufficiently characterized. We compared the effects of more intensive, long-term blood pressure (BP) lowering using a novel single “triple-pill” (fixed low-dose combination of telmisartan 20 mg, amlodipine 2.5 mg and indapamide 1.25 mg) versus placebo on disability and HRQoL in patients with ICH. There is uncertainty over how the effects of BP control for secondary prevention translate into functional recovery and wellbeing. Methods TRIDENT was international, double-blind, placebo-controlled trial in adults with ICH and mild–moderate hypertension (systolic BP 130-160 mmHg) receiving background antihypertensive therapy, provided triple-pill/placebo could be added. Overall, 1670 participants (mean age 58 years) were randomized to triple-pill (n = 833 to triple-pill; mean achieved SBP 127 mmHg) or placebo (n = 837; mean SBP 138 mmHg) and followed for a mean of 3 years. Recurrent stroke occurred in 38 (4.6%) in the triple-pill group and 62 (7.4%) in the placebo group (HR 0.61, 95%CI 0.41-0.92; P = 0.015). Functional status was assessed using the simplified modified Rankin scale (smRS), and HRQoL was assessed with the EuroQoL EQ-5D-3L VAS (Visual Analogue Scale) at baseline and at scheduled follow-up visits. Results The effects of triple-pill treatment on disability-free survival, HRQoL, and patterns of recovery will be presented. Conclusions Intensive BP lowering with a fixed low-dose triple combination may improve broader patient-centered outcomes after ICH. Conflict of interest Funding from the National Health and Medical Research Council (NHMRC) of Australia. The authors have no other conflicts to declare.