Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease

Christophe Tzourio, Craig Anderson, Neil Chapman, Mark Woodward, Bruce Neal, Stephen MacMahon, John Chalmers

Research output: Contribution to journalArticle

Abstract

Background: High blood pressure and stroke are associated with increased risks of dementia and cognitive impairment. This study aimed to determine whether blood pressure lowering would reduce the risks of dementia and cognitive decline among individuals with cerebrovascular disease. Methods: The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, double-blind, placebo-controlled trial conducted among 6105 people with prior stroke or transient ischemic attack. Participants were assigned to either active treatment (perindopril for all participants and indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo(s). The primary outcomes for these analyses were dementia (using DSM-IV criteria) and cognitive decline (a decline of 3 or more points in the Mini-Mental State Examination score). Results: During a mean follow-up of 3.9 years, dementia was documented in 193 (6.3%) of the 3051 randomized participants in the actively treated group and 217 (7.1%) of the 3054 randomized participants in the placebo group (relative risk reduction, 12% [95% confidence interval, -8% to 28%]; P=.2). Cognitive decline occurred in 9.1% of the actively treated group and 11.0% of the placebo group (risk reduction, 19% [95% confidence interval, 4% to 32%]; P=.01). The risks of the composite outcomes of dementia with recurrent stroke and of cognitive decline with recurrent stroke were reduced by 34% (95% confidence interval, 3% to 55%) (P=.03) and 45% (95% confidence interval, 21% to 61%) (P

Original languageEnglish (US)
Pages (from-to)1069-1075
Number of pages7
JournalArchives of Internal Medicine
Volume163
Issue number9
DOIs
StatePublished - May 12 2003
Externally publishedYes

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Indapamide
Perindopril
Cerebrovascular Disorders
Dementia
Stroke
Blood Pressure
Placebos
Confidence Intervals
Risk Reduction Behavior
Therapeutics
Transient Ischemic Attack
Diuretics
Diagnostic and Statistical Manual of Mental Disorders
Cognitive Dysfunction
Hypertension

ASJC Scopus subject areas

  • Internal Medicine

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Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. / Tzourio, Christophe; Anderson, Craig; Chapman, Neil; Woodward, Mark; Neal, Bruce; MacMahon, Stephen; Chalmers, John.

In: Archives of Internal Medicine, Vol. 163, No. 9, 12.05.2003, p. 1069-1075.

Research output: Contribution to journalArticle

Tzourio, Christophe ; Anderson, Craig ; Chapman, Neil ; Woodward, Mark ; Neal, Bruce ; MacMahon, Stephen ; Chalmers, John. / Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. In: Archives of Internal Medicine. 2003 ; Vol. 163, No. 9. pp. 1069-1075.
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