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Wiley InterScience | ||||||||
  Clinical and Experimental Pharmacology and PhysiologyVolume 23 Issue 5, Pages 444 - 446 Published Online: 28 Jun 2007 Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd
Abstract | References | Full Text: PDF (Size: 294K) | Related Articles | Citation Tracking  BLOOD PRESSURE LOWERING IN PATIENTS WITH CEREBROVASCULAR DISEASE: RESULTS OF THE PROGRESS (PERINDOPRIL PROTECTION AGAINST RECURRENT STROKE STUDY) PILOT PHASE Copyright 1996 Blackwell Publishing Asia Pty Ltd KEYWORDS angiotensin converting enzyme inhibitor • cerebrovascular • diuretic • hypertension • indapamide • perindopril • randomized clinical trial • stroke ABSTRACT
1. Among patients with cerebrovascular disease, there is a direct and continuous association between blood pressure and the risk of stroke, but previous trials of blood pressure lowering in this patient group have been inconclusive. 2. PROGRESS (Perindopril Protection Against Recurrent Stroke Study) is a multicentre, randomized, placebo-controlled trial that aims to determine reliably the effect of angiotensin converting enzyme (ACE) inhibitor-based blood pressure lowering on stroke risk in patients with a history of cerebrovascular disease. If a 4 week run-in period on active perindopril is well tolerated, participants are randomized to either perindopril (4 mg) ± indapamide (2.5 mg) or matching placebo(s). The primary study outcome is stroke and follow-up is for a minimum of 4 years. 3. For the pilot study nearly 5000 medical records were screened and 60 patients with recent cerebrovascular events were approached directly in hospital or at a clinic visit. Sixtyseven patients entered the run-in phase (52 from retrospective screening and 15 by prospective approach) and 60 patients proceeded to randomization. Treatment with perindopril was well tolerated; only three patients were withdrawn due to side effects and four were withdrawn for other reasons. The mean age of randomized patients was 68 years; 70% were male and 55% were 'non-hypertensive'. The mean entry blood pressure was 142/83 mmHg and following pre-randomization treatment this was reduced by 7/4 mmHg. 4. Most patients were identified by retrospective review of medical records, but this was less efficient than prospective methods. Blood pressure lowering was well tolerated by both hypertensive and non-hypertensive patients with cerebrovascular disease. The small numbers of patients and the nonrandomized nature of the data reported limit the conclusions that can be drawn, but the results confirm the feasibility of the main study. Received 2 February 1996, revision 6 February 1996, accepted 8 February 1996 | 
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