[Reduced risk of stroke recurrence due to hypotensive medication, irrespective of the initial blood pressure].
The 'Perindopril protection against recurrent stroke study' (PROGRESS) demonstrated that for patients with a history of stroke or transient ischaemic attack during the previous 5 years, a blood-pressure-lowering regimen based on the combination of a diuretic and an angiotensin-converting enzyme (ACE) inhibitor, reduces the risk of stroke recurrence (fatal and non-fatal) by 28% (95%-CI: 17-38). This effect was irrespective of the initial neurological diagnosis (ischaemic or haemorrhagic stroke) and blood pressure level. Patients who were treated with just the ACE inhibitor did not exhibit these effects. This large-scale clinical trial demonstrates that hypotensive medication in the form of a diuretic combined with an ACE inhibitor is a beneficial strategy for the secondary prevention of stroke in normotensive and hypertensive patients.
Lenders
J W M
JW
Universitair Medisch Centrum, afd. Algemeen Interne Geneeskunde, Postbus 9101, 6500 HB Nijmegen. j.lenders@aig.azn.nl
Thien
Th
T
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000517:prevention & control*; D004232:Diuretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D012008:Recurrence; D016019:Survival Analysis
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics