Triple pill lowers risk of recurrent stroke by 39%

Researchers report that GMRx2, a single daily pill combining telmisartan 20mg, amlodipine 2.5mg, and indapamide 1.25mg, lowers the risk of recurrent stroke by 39%.

The findings from the TRIDENT trial appeared on Aprill 22, 2026 in the NEJM/New England Journal of Medicine.

Professor Craig Anderson, Principal Investigator and Senior Professorial Fellow at The George Institute, based in Sydney, Australia. said, “Lowering blood pressure is the only proven method to prevent another stroke, yet achieving good blood pressure control is a real challenge. One big issue is that the number and doses of antihypertensive medications are not increased when needed and doctors and patients struggle with complex pill regimens.”

“Our study showed that GMRx2, a once-daily triple combination pill, cut the risk of another stroke by 39%. These findings could translate to important treatment benefits for the millions of people affected by intracerebral haemorrhage worldwide who face a high risk of having another one,” he added.

The researchers conducted a multi-national, double-blind, randomized, placebo-controlled trial, enrolling subjects with a history of intracerebral hemorrhage.

Patients were eligible for enrollment if they had a systolic blood pressure of 130 to 160 mm Hg at baseline and were in clinically stable condition.

Following 2 weeks of run-in treatment. in which all subjects received the once-daily triple pill, they were randomized to continue receiving the triple pill or to receive a matching placebo.

Of 1670 subjects who underwent randomization, 833 were assigned to receive the triple pill and 837 to receive a placebo.

The mean age of the subjects was 58 years.

The primary outcome was the first recurrent stroke. Secondary outcomes included blood-pressure control, major cardiovascular events, death from cardiovascular causes, and safety.

At a median follow-up of 2.5 years, recurrent stroke was reported in 38 subjects (4.6%) in the triple pill group and 62 subjects (7.4%) in the placebo group. This translated to a 39% lower risk of recurrent stroke for the subjects treated with the triple pill.

The subjects treated with the triple pill also achieved reduced rates of major cardiovascular events (non-fatal stroke, non-fatal heart attack and cardiovascular death), by 33% versus placebo.

Serious adverse events were comparable between the triple pill and placebo groups, affecting 23.8% and 26.8% of patients, respectively.

Professor Anderson added, “We hope GMRx2 is approved for this indication by regulatory authorities throughout the world, and, if so, that it is widely used as an effective approach with the potential to improve the outcome for patients affected by intracerebral haemorrhage, and also ischaemic stroke, across the globe.”