What’s the Optimal Approach to Prevent a Second Intracerebral Hemorrhage?

Persistently uncontrolled high blood pressure (BP) after an intracerebral hemorrhage (ICH) is a major risk factor for recurrent stroke. To determine if single-pill combination therapy decreases this risk, investigators randomized nearly 1700 adults from 12 countries (two thirds from Sri Lanka) with sustained hypertension after an ICH to either a daily low-dose triple combination pill containing telmisartan 20 mg, amlodipine 2.5 mg, and indapamide 1.25 mg, or placebo. Both groups received usual care for BP control according to regional guidelines, with additional antihypertensive medications permitted to reach locally recommended targets (systolic BP <130 or <140 mm Hg, depending on site).