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 (copyof the brain imaging report to be uploaded to the database, labelled withparticipant identification (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 clinicsite to 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.simplified modified Rankin Scale (smRS) of 4-5] or significant memory or behaviouraldisorder)

Exclusion Criteria for MRI (as applies)

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