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“Three-in-one blood pressure pill can significantly reduce risk of recurrent strokes”

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A major international clinical trial has found that a once-daily, three-in-one blood pressure pill can significantly reduce the risk of recurrent strokes among patients who have survived a brain bleed, or haemorrhagic stroke, Kelaniya University’s media division announced yesterday.

The TRIDENT trial, coordinated in Sri Lanka by a team led by Senior Professor Asita de Silva of the Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, showed that the low-dose combination pill reduced the risk of a repeat stroke by up to 40 per cent and the risk of another brain bleed by 60 per cent among high-risk patients. The findings were published on April 23 in the New England Journal of Medicine.

The pill combines three commonly used antihypertensive medications—amlodipine, telmisartan and indapamide—into a single daily dose. Researchers said the simplified regimen improves patient adherence and supports better blood pressure control, a key factor in preventing further strokes, heart attacks and other cardiovascular complications.

The trial followed 1,670 stroke survivors across 11 countries over a seven-year period, including participants from 11 specialist neurology centres in Sri Lanka. Nearly 73 per cent of participants were Asian, with close to 70 per cent from Sri Lanka, making the findings particularly relevant to the country and the wider South Asian region.

An estimated 60,000 people in Sri Lanka suffer strokes annually, while cardiovascular disease accounts for more than 40 per cent of all deaths. Around 40 per cent of Sri Lankan adults aged 30 to 79 are affected by high blood pressure, the leading risk factor for stroke.

Professor de Silva said a decade of clinical trials involving Sri Lankan and international researchers had consistently shown the effectiveness of a triple low-dose combination therapy in controlling blood pressure. He noted that the drug has recently been approved by the U.S. Food and Drug Administration and included in the World Health Organization’s Model List of Essential Medicines. He described the findings as a “game changer” in reducing recurrent stroke risk through sustained blood pressure control.

He also highlighted Sri Lanka’s significant contribution to the study, noting that nearly 70 per cent of the trial data was generated locally, underscoring the country’s growing role in global medical research.

Dr. Bimsara Senanayake, Specialist Neurologist and Lead Investigator at the National Hospital of Sri Lanka, said the findings address longstanding gaps in the treatment of intracerebral haemorrhage, where effective strategies for intensive blood pressure management have remained uncertain for decades. He noted that improved blood pressure control could substantially reduce the risk of further life-threatening events among survivors.

In a statement, World Stroke Organization President Professor Jeyaraj Pandian described the trial as a major advance in stroke prevention, highlighting the benefits of effective blood pressure management following intracerebral haemorrhage.

The findings are expected to inform changes in clinical practice, particularly as the triple-combination pill used in the trial has already received regulatory approval and global recognition for the treatment of hypertension.

Dr. Ajantha Keshavaraj, President of the Association of Sri Lankan Neurologists and a co-author of the study, said the results could significantly change the management of post-stroke blood pressure, adding that the treatment—combined with lifestyle measures such as reduced salt intake—has the potential to save thousands of lives.

An accompanying editorial in the New England Journal of Medicine also underscored the importance of strict blood pressure control as a priority in preventing cardiovascular disease.



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Move to extend judges’ retirement ages could damage Sri Lanka’s global image, warns Prof. Peiris

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Prof.Peiris

Former Foreign Minister Prof. G. L. Peiris yesterday warned that any move by the government to extend the retirement age of superior court judges could have serious repercussions for Sri Lanka’s international standing, particularly ahead of the next session of the UN Human Rights Council (UNHRC), in Geneva, in September.

Addressing a media briefing, organised by the People’s United Opposition, at its Flower Road, Colombo office, Prof. Peiris claimed that attempts to interfere with the judiciary, through extensions of judges’ terms, would undermine the credibility of Sri Lanka’s courts and weaken the country’s position before the international community.

Prof. Peiris said there was widespread opposition to the proposal to extend the superior court judges’ tenure by two years, with lawyers’ organisations, academics and civil society groups expressing concerns over the move.

“There is no clarity whatsoever from the government’s side,” Prof. Peiris said, claiming that unlike in other countries where such proposals were subjected to lengthy public consultations, there had been no transparency regarding the government’s intentions.

He argued that if such extensions were granted to judges, similar privileges would have to be considered for other sectors, including the public service, university academics and medical specialists.

Prof. Peiris said the issue had gained greater significance due to Sri Lanka’s engagement with the UNHRC, which he described as having established a special investigative mechanism relating to the country.

He alleged that the politicisation of the judiciary would provide further grounds for international criticism against Sri Lanka, which was already facing scrutiny over alleged human rights issues.

“The next session of the UN Human Rights Council will be held in Geneva, in September,” Prof. Peiris said. “This issue will not only affect our country internally, but will also cause serious damage to Sri Lanka internationally.”

He claimed that Sri Lanka had previously defended itself against international interventions by highlighting the independence and reputation of its judicial system.

Referring to the country’s legal history, Prof. Peiris said Sri Lanka had possessed a judiciary respected globally, citing former Supreme Court Judge Dr. Christopher Weeramantry’s tenure as Vice-President of the International Court of Justice in The Hague as an example of international recognition of Sri Lankan judicial expertise.

He said that during his tenure as Foreign Minister, he had maintained that Sri Lanka’s own courts were capable of addressing domestic issues and that foreign intervention was unnecessary.

Prof. Peiris also referred to discussions he had held with Russian Foreign Minister Sergei Lavrov and Chinese Foreign Minister Wang Yi, claiming that both had supported Sri Lanka’s position that external interference in domestic matters should not be permitted.

However, he alleged that the current situation was different, claiming that the judiciary was being politicised through selective extensions of service while vacancies remained in the Supreme Court and Court of Appeal.

He questioned why judicial vacancies had not been filled if the government’s stated objective was to reduce delays in the administration of justice.

“The responsibility of filling these vacancies lies with the executive,” he said, adding that the failure to do so could affect the international reputation of Sri Lanka’s judiciary.

Prof. Peiris also claimed that the Bar Association of Sri Lanka had repeatedly called for the vacancies to be filled, warning that the present developments could have an adverse impact on the country’s standing internationally.

He questioned whether it was justified to place Sri Lanka in a difficult international position to serve, what he described as, “a narrow and partisan political objective.”

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Dengue surge infects 76,000, claims about 53 lives

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The total number of dengue cases reported in Sri Lanka so far this year has risen to 76,044, with health authorities warning the public to remain vigilant amid a continued surge in infections.

The National Dengue Control Unit (NDCU) said 2,652 dengue cases had been reported on Sunday (19) alone, while 162 Medical Officer of Health (MOH) divisions across the country continue to be classified as high-risk dengue zones.

The latest figures indicate a sharp rise in dengue infections during the past few months, with 8,590 cases recorded in May, followed by 21,537 cases in June. A further 20,666 cases have been reported during the first 19 days of July.

The dengue outbreak has claimed 53 lives so far this year, with the case fatality rate standing at 0.07%, according to the NDCU.

The Western Province remains the worst affected region, accounting for 40,009 cases, or 52.61% of the country’s total infections. The Southern Province has recorded 11,707 cases (15.40%), while the Central Province has reported 6,431 cases (8.46%).

At district level, Gampaha has recorded the highest number of dengue infections with 15,910 cases, followed closely by Colombo with 15,110 cases. Of the Colombo District cases, 3,073 were reported within the Colombo Municipal Council area.

Matara has recorded 5,330 cases, Kandy 5,111 cases and Kalutara 5,010 cases.

Health authorities have urged the public to take preventive measures by keeping their surroundings clean and eliminating mosquito breeding grounds, particularly amid prevailing rainy conditions.The public has also been advised to seek immediate medical attention if symptoms such as fever develop, as early medical intervention is essential in preventing severe complications from dengue.

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SC dismisses challenge to gender change procedures

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The Supreme Court yesterday dismissed, without taking up for consideration, a Fundamental Rights petition seeking to invalidate a circular that permits individuals in Sri Lanka to change their gender legally .

The petition had been filed by retired Sri Lanka Air Force (SLAF) Warrant Officer Shantha Jayathilake, who challenged the legality of procedures allowing individuals to alter their gender designation following medical and psychiatric assessments.

Former Presidents Maithripala Sirisena and Ranil Wickremesinghe, as well as incumbent President Anura Kumara Dissanayake, were among those named as respondents in the petition.

The petitioner alleged that successive governments, including the present administration, had facilitated gender changes through medical procedures in a manner contrary to Sri Lankan law.

Jayathilake contended that the law did not permit a person to change their sex from male to female or female to male through medical intervention in the absence of a biological basis. He further argued that individuals had been allowed to alter their gender identity on the recommendation of a psychiatrist, under guidelines issued in 2016 by the then Director General of Health Services.

The petitioner also claimed that authorities had been issuing revised birth certificates and National Identity Cards to persons who had undergone gender-transition procedures, maintaining that such actions were unlawful.

However, the Supreme Court declined to entertain the application and dismissed the petition without granting leave to proceed.

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