A single pill that cuts the risk of a second stroke

High blood pressure is one of the leading causes of cardiovascular disease and stroke in South Asia. Over more than a decade, the partnership has helped build the evidence base for low-dose combination therapy through a series of connected trials.

COBRA-BPS showed that a multi-component, community-delivered intervention improved blood pressure control in rural populations in Bangladesh, Pakistan and Sri Lanka, and that it was affordable at scale.

TRIUMPH demonstrated that early use of a triple-pill combination controlled blood pressure better than usual care in Sri Lanka.

TRIDENT, published in the New England Journal of Medicine in 2026, showed that intensive long-term blood pressure control with a low-dose triple single pill reduced the risk of recurrent stroke by 40% in patients who had suffered a brain haemorrhage.

Together, this body of work contributed to the World Health Organization’s recognition of triple fixed-dose combination therapies for hypertension as essential medicines. A treatment tested in Sri Lankan hospitals is now part of how the world treats high blood pressure.