ABSTRACT NUMBER: ESOC2026LB128 LB128 - EFFECTS OF INTENSIVE BLOOD PRESSURE LOWERING ON COGNITIVE FUNCTION AND DEMENTIA IN PATIENTS WITH INTRACEREBRAL HEMORRHAGE: TRIDENT RESULTS

Abstract Background and aims Suvivors of intracerebral hemorrhage (ICH) are at high-risk of subsequent cognitive impairment and dementia. We aimed to determine the effects of more intensive long-term blood pressure (BP) lowering with a novel single ‘triple-pill’ (fixed low-dose combination of telmisartan 20mg, amlodipine 2.5mg and indapamide1.25mg) versus placebo on cognitive function/dementia in patients with ICH. Methods TRIDENT was international, double-blind, placebo-controlled trial in adults with ICH and mild-moderate hypertension (SBP 130-160mmHg) on any background antihypertensive therapy provided triple-pill/placebo could be added. The main results have been presented: of 1670 randomized patients (mean age 58 years), 833 to triple-pill (mean SBP 127mmHg) and 837 to placebo (mean SBP 138mmHg) with a mean 3 years of follow-up, 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). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) in all participants at baseline and regular intervals during follow-up. A 3-step screen-adjudication process using the Quick Dementia Rating Scale and other tools was undertaken to diagnose dementia and mild cognitive impairment (MCI) at the penultimate or final visits in surviving participants. Results The cognitive outcomes of survival-free of dementia and MCI are available in 995 participants, and MoCA scores over time in all participants. The treatment effects will be presented at the conference Conclusions Fixed triple low-dose combination BP lowering could improve cognitive outcomes after ICH. Conflict of interest