Degree of blood pressure reduction and recurrent stroke: The PROGRESS trial

Hisatomi Arima, Craig Anderson, Teruo Omae, Mark Woodward, Stephen MacMahon, Giuseppe Mancia, Marie Germaine Bousser, Christophe Tzourio, Stephen Harrap, Lisheng Liu, Bruce Neal, John Chalmers

Research output: Contribution to journalArticlepeer-review

Abstract

Objective There is ongoing controversy regarding a 'J-curve' phenomenon such that low and high blood pressure (BP) levels are associated with increased risks of recurrent stroke. We aimed to determine whether large treatment-related BP reductions are associated with increased risks of recurrent stroke. Design Data are from the PROGRESS trial, where 6105 patients with cerebrovascular disease were randomly assigned to either active treatment (perindopril±indapamide) or placebo(s). There were no BP criteria for entry. BP was measured at every visit, and participant groups defined by reduction in systolic BP (SBP) from baseline were used for the analyses. Outcome was recurrent stroke. Results During a mean follow-up of 3.9 years, 727 recurrent strokes were observed. There were clear associations between the magnitude of SBP reduction and the risk of recurrent stroke. After adjustment for cardiovascular risk factors and randomised treatment, annual incidence was 2.08%, 2.10%, 2.31% and 2.96% for participant groups defined by SBP reductions of ≥20, 10-19, 0-9 and

Original languageEnglish
JournalJournal of Neurology, Neurosurgery and Psychiatry
DOIs
Publication statusAccepted/In press - May 14 2014

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Surgery
  • Psychiatry and Mental health
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Degree of blood pressure reduction and recurrent stroke: The PROGRESS trial'. Together they form a unique fingerprint.

Cite this