Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack

S. MacMahon, B. Neal, C. Tzourio, A. Rodgers, M. Woodward, J. Cutler, C. Anderson, J. Chalmers, T. Ohkubo, M. G. Bouser, S. Davis, G. Donnan, L. Hansson, S. Harrap, K. R. Lees, L. Liu, G. Mancia, B. Neal, T. Omae, J. ReidA. Rodgers, R. Sega, A. Terent, C. Tzourio, C. Warlow, M. Woodward, N. Anderson, C. Bladin, B. Chambers, G. Gordon, N. Sharpe, R. Collins, P. Sandercock, J. Simes, P. Sleight, A. Brnabic, S. Colman, L. Francis, A. Lee, L. Gong, M. G. Bousser, T. Yamaguchi, K. R. Lees, F. William, Q. Deng, D. X. Hu, W. Wang, A. L. Wu, L. Y. Ma, Z. Y. Tao, V. Biousse, K. Berthet, L. Ben Slamia, C. Le Denmat, S. Crespi, G. Foglia, C. Fujimoto, S. Matsumura, K. Marttala, M. Pettersson, M. Safwenberg, J. Fenton, Y. McIlvenna, R. Currie, H. Bartram, J. Briad, A. Clague, Y. Cleverly, M. Cosson, A. Culpan, D. Douglas, S. Flett, B. Gray, T. Holloway, A. Milne, R. Prasad, Y. Ratnasabapathy, A. Santos, M. Wills, T. Agnew, N. Chapman, N. Lewis, B. Mullane

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Abstract

Background: Blood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack. Methods: 6105 individuals from 172 centres in Asia, Australasia, and Europe were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised a flexible regimen based on the angiotensin-converting-enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. The primary outcome was total stroke (fatal or non-fatal). Analysis was by intention to treat. Findings: Over 4 years of follow up, active treatment reduced blood pressure by 9/4 mm Hg. 307 (10%) individuals assigned active treatment suffered a stroke, compared with 420 (14%) assigned placebo (relative risk reduction 28% [95% CI 17-38], p

Original languageEnglish
Pages (from-to)1033-1041
Number of pages9
JournalLancet
Volume358
Issue number9287
DOIs
Publication statusPublished - Sep 29 2001

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ASJC Scopus subject areas

  • Medicine(all)

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MacMahon, S., Neal, B., Tzourio, C., Rodgers, A., Woodward, M., Cutler, J., Anderson, C., Chalmers, J., Ohkubo, T., Bouser, M. G., Davis, S., Donnan, G., Hansson, L., Harrap, S., Lees, K. R., Liu, L., Mancia, G., Neal, B., Omae, T., ... Mullane, B. (2001). Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet, 358(9287), 1033-1041. https://doi.org/10.1016/S0140-6736(01)06178-5