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Wiley InterScience | ||||||
  Clinical and Experimental Pharmacology and PhysiologyVolume 28 Issue 12, Pages 1091 - 1095 Published Online: 6 Jan 2002 Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd
Abstract | References | Full Text: HTML, PDF (Size: 37K) | Related Articles | Citation Tracking  Progress In Reducing The Burden Of Stroke* *A full account of the PROGRESS trial has been published elswhere (Lancet 2001; 358: 1033–41). Presented at the IIIrd Franco–Australian Meeting on Hypertension, Corsica, France, June 2001. The papers in these proceedings have been peer reviewed. Copyright Blackwell Science Asia Pty Ltd KEYWORDS angiotensin-converting enzyme inhibitors • blood pressure lowering • dementia • disability and dependency • diuretics • hypertension • indapamide • major coronary events • perindopril • stroke ABSTRACTSUMMARY1. The burden of stroke worldwide is growing rapidly, driven by an ageing population and by the rapid rate of urbanization and industrialization in the developing world. There are approximately 5 million fatal and 15 million non-fatal strokes each year and over 50 million survivors of stroke alive, worldwide, today. 2. The most important determinant of stroke risk is blood pressure, with a strong, continuous relationship between the level of the systolic and diastolic pressures and the risk of initial and recurrent stroke, in both Western and Asian populations. 3. Randomized clinical trials have clearly demonstrated that blood pressure lowering reduces the risk of initial stroke by 35–40% in hypertensive patients; but, until recently, there was no conclusive evidence that blood pressure lowering was effective in the secondary prevention of stroke. 4. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) has provided definitive evidence that blood pressure lowering in patients with previous stroke or transient ischaemic attack (TIA) reduces the incidence of secondary stroke by 28%, of major vascular events by 26% and of major coronary events by 26%. These reductions were all magnified by approximately 50% in a subgroup of patients in whom the angiotensin-converting enzyme inhibitor perindopril was routinely combined with the diuretic indapamide. 5. Successful global implementation of a treatment with perindopril and indapamide in patients with a history of stroke or TIA would markedly reduce the burden of stroke and could avert between 0.5 and one million strokes each year, worldwide.
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