@article{8851d22a20944e0487fef35fa7364532,
title = "Lower blood pressure and risk of recurrent stroke in patients with chronic kidney disease: PROGRESS trial",
abstract = "Recent epidemiological studies have shown a J-shaped association between the risk of stroke and systolic blood pressure (SBP) levels in people with chronic kidney disease (CKD). The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, placebo-controlled trial demonstrating that perindopril-based blood pressure (BP) lowering reduced the risk of stroke in 6105 participants with prior cerebrovascular disease. We estimated the effects of therapy on the risk of recurrent stroke in 1757 of these participants with stage 3 or greater CKD according to baseline BP and the relationship between achieved follow-up BP and the risk of stroke. Active therapy produced comparable and significant reductions in the risk of stroke across all baseline SBP levels. The age- and gender-adjusted incidence of stroke increased significantly in a log-linear relationship for achieved SBP levels and strokes per 1000 person-years. This association persisted after adjusting for potential confounding factors. We found that perindopril-based BP lowering effectively prevented recurrent stroke in people with CKD, across a wide range of BP levels, without evidence of an increased risk of stroke in people with low BP levels.",
keywords = "Blood pressure, Cardiovascular disease, Chronic kidney disease, Stroke",
author = "T. Ninomiya and V. Perkovic and M. Gallagher and M. Jardine and A. Cass and H. Arima and C. Anderson and B. Neal and M. Woodward and T. Omae and S. MacMahon and J. Chalmers",
note = "Funding Information: John Chalmers and Stephen MacMahon hold research grants from Servier as a Chief Investigators for the PROGRESS and ADVANCE trials, administered by the University of Sydney. John Chalmers, Stephen MacMahon, Craig Anderson, Bruce Neal, and Vlado Perkovic have also received honoraria from Servier for speaking in relation to PROGRESS and/or ADVANCE at scientific meetings. Funding Information: PROGRESS was funded by grants from Servier, the Health Research Council of New Zealand, and the National Health and Medical Research Council (NHMRC) of Australia. The study was designed, conducted, analyzed, and interpreted by the investigators independent of all sponsors. The research was supported by Banyu Life Science Foundation Fellowship and International Society of Hypertension Visiting Postdoctoral Award from the Foundation for High Blood Pressure Research in Australia (Dr Ninomiya) and Heart Foundation of Australia and the Royal Australasian College of Physicians Pfizer Cardiovascular Research fellowship (Dr Perkovic). Bruce Neal holds a Career Development Award from the National Heart Foundation of Australia. Alan Cass holds a Senior Research Fellowship from the NHMRC of Australia.",
year = "2008",
month = apr,
doi = "10.1038/ki.2008.5",
language = "English (US)",
volume = "73",
pages = "963--970",
journal = "Kidney international",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "8",
}