TY - JOUR
T1 - Effects of a perindopril-based blood pressure lowering regimen on cardiac outcomes among patients with cerebrovascular disease
AU - Chaturvedi, V.
AU - Patel, A.
AU - Chalmers, John
AU - Chapman, N.
AU - Hansson, L.
AU - MacMahon, S.
AU - Mancia, G.
AU - Neal, B.
AU - Reid, J.
AU - Sharpe, N.
AU - Woodward, M.
PY - 2003/3
Y1 - 2003/3
N2 - Aim: To determine the effects of a perindopril-based blood pressure lowering regimen on major cardiac events among hypertensive and non-hypertensive patients with a history of cerebrovascular disease. Methods and results: A total of 6105 individuals with a history of stroke or transient ischaemic attack were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised the angiotensin-converting -enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. Over a mean of 3.9 years of follow-up, active treatment reduced blood pressure by 9/4 mmHg compared with placebo and reduced the primary outcome, stroke, by 28%. Major coronary events occurred in 269 participants (active 3.8%, placebo 5.0%) and heart failure was diagnosed in 264 participants (active 3.7%, placebo 4.9%). Active treatment reduced the risk of major coronary events by 26% (95% CI; 6-42%; p=0.02) and the risk of congestive heart failure by 26% (5-42%; p=0.02). For each of these outcomes, there was no clear evidence of differences between the treatment effects in participants classified as hypertensive or non-hypertensive, and those with or without a history of coronary heart disease. Conclusions: Among individuals with cerebrovascular disease, blood pressure lowering with a regimen involving perindopril and indapamide not only reduced the risk of stroke, but also substantially reduced the risks of cardiac outcomes.
AB - Aim: To determine the effects of a perindopril-based blood pressure lowering regimen on major cardiac events among hypertensive and non-hypertensive patients with a history of cerebrovascular disease. Methods and results: A total of 6105 individuals with a history of stroke or transient ischaemic attack were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised the angiotensin-converting -enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. Over a mean of 3.9 years of follow-up, active treatment reduced blood pressure by 9/4 mmHg compared with placebo and reduced the primary outcome, stroke, by 28%. Major coronary events occurred in 269 participants (active 3.8%, placebo 5.0%) and heart failure was diagnosed in 264 participants (active 3.7%, placebo 4.9%). Active treatment reduced the risk of major coronary events by 26% (95% CI; 6-42%; p=0.02) and the risk of congestive heart failure by 26% (5-42%; p=0.02). For each of these outcomes, there was no clear evidence of differences between the treatment effects in participants classified as hypertensive or non-hypertensive, and those with or without a history of coronary heart disease. Conclusions: Among individuals with cerebrovascular disease, blood pressure lowering with a regimen involving perindopril and indapamide not only reduced the risk of stroke, but also substantially reduced the risks of cardiac outcomes.
KW - ACE inhibitor
KW - Blood pressure
KW - Congestive heart failure
KW - Coronaryheart disease
KW - Diuretic
KW - Indapamide
KW - Perindopril
KW - Randomised trial
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U2 - 10.1016/S0195-668X(02)00804-7
DO - 10.1016/S0195-668X(02)00804-7
M3 - Article
C2 - 12633548
AN - SCOPUS:0037337368
VL - 24
SP - 475
EP - 484
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 5
ER -