Triple Therapy Prevention of Recurrent Intracerebral Disease EveNts Trial

Inclusion Criteria:

• Adults (≥18 years) with a history of primary ICH that is confirmed by imaging (copy ofthe brain imaging report to be uploaded to the database, labelled with participantidentification (ID) and with personal identifiers removed)
• Clinically stable, as judged by investigator
• Average of two resting SBP levels measured 5 minutes apart in the range 130-160mmHgrecorded in a seated position (National Heart Foundation of Australia Guidelines). (Patients with higher SBP can be included if considered by attending clinician thatmanagement is consistent with local standards of clinical practice)
• Geographical proximity to the recruiting hospital and/or follow-up medical clinic siteto allow ready access for in-person clinic visits during follow-up
• No clear contraindication to any of the study treatments
• Provision of written informed consent

Exclusion Criteria:

• Taking an ACE-I that cannot be switched to any of the following alternatives:
• telmisartan 20 or 40mg, amlodipine 2.5 or 5mg, indapamide 1.25mg, or
• an equivalent class (ARB, CCB or thiazide [TZ]-like diuretic), or
• a BB
• Contraindication to any of the study medications, in the context of currentlyprescribed BP-lowering medication
• Unable to complete the study procedures and/or follow-up
• Females of child-bearing age and capability, who are pregnant or breast-feeding, orthose of child-bearing age and capability who are not using adequate birth control
• Significant hyperkalaemia and/or hyponatremia, in the opinion of the responsiblephysician
• Estimated glomerular filtration rate (eGFR) <30mL/min/1.73m2
• Severe hepatic impairment (alanine aminotransferase [ALT] or aspartateaminotransferase [AST] >3x the upper limit of normal [ULN])
• Any other condition that in the opinion of the responsible physician or investigatorrenders the patient unsuitable for the study (e.g. severe disability [i.e. simplifiedmodified Rankin Scale (smRS) of 4-5] or significant memory or behavioural disorder) Exclusion Criteria for MRI (as applies)

• Any MRI contraindication (e.g. metallic implants, claustrophobia, etc) or participantrefusal.