PROGRESS
Trial question
What is the role of perindopril-based BP lowering regimen in patients with a history of stroke or TIA?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
30.0% female
70.0% male
N = 6105
6105 patients (1852 female, 4253 male).
Inclusion criteria: patients with a history of stroke or TIA.
Key exclusion criteria: definite indication or contraindication for treatment with ACEis; < 2 weeks of clinical stability after the most recent vascular event.
Interventions
N=3051 active treatment (a flexible regimen based on perindopril 4 mg daily, with the addition of indapamide at the discretion of treating physicians).
N=3054 placebo (matching perindopril and indapamide placebo).
Primary outcome
Stroke
10%
14%
14.0 %
10.5 %
7.0 %
3.5 %
0.0 %
Active
treatment
Placebo
Significant
decrease ▼
NNT = 25
Significant decrease in stroke (10% vs. 14%; RR 0.72, 95% CI 0.62 to 0.83).
Secondary outcomes
Significant increase in composite outcome of nonfatal stroke, nonfatal MI, or death from a vascular cause (15% vs. 20%; RR 26, 95% CI 16 to 34).
No significant difference in all-cause mortality (10% vs. 10.4%; RR 0.96, 96% CI 0.82 to 1.12).
Significant decrease in hospital admissions (41% vs. 44%; RR 0.91, 95% CI 0.85 to 0.99).
Conclusion
In patients with a history of stroke or TIA, active treatment was superior to placebo with respect to stroke.
Reference
PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001 Sep 29;358(9287):1033-41.
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