Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack

S. MacMahon, B. Neal, C. Tzourio, A. Rodgers, M. Woodward, J. Cutler, C. Anderson, J. Chalmers, T. Ohkubo, M. G. Bouser, S. Davis, G. Donnan, L. Hansson, S. Harrap, K. R. Lees, L. Liu, G. Mancia, B. Neal, T. Omae, J. ReidA. Rodgers, R. Sega, A. Terent, C. Tzourio, C. Warlow, M. Woodward, N. Anderson, C. Bladin, B. Chambers, G. Gordon, N. Sharpe, R. Collins, P. Sandercock, J. Simes, P. Sleight, A. Brnabic, S. Colman, L. Francis, A. Lee, L. Gong, M. G. Bousser, T. Yamaguchi, K. R. Lees, F. William, Q. Deng, D. X. Hu, W. Wang, A. L. Wu, L. Y. Ma, Z. Y. Tao, V. Biousse, K. Berthet, L. Ben Slamia, C. Le Denmat, S. Crespi, G. Foglia, C. Fujimoto, S. Matsumura, K. Marttala, M. Pettersson, M. Safwenberg, J. Fenton, Y. McIlvenna, R. Currie, H. Bartram, J. Briad, A. Clague, Y. Cleverly, M. Cosson, A. Culpan, D. Douglas, S. Flett, B. Gray, T. Holloway, A. Milne, R. Prasad, Y. Ratnasabapathy, A. Santos, M. Wills, T. Agnew, N. Chapman, N. Lewis, B. Mullane

Research output: Contribution to journalArticle

Abstract

Background: Blood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack. Methods: 6105 individuals from 172 centres in Asia, Australasia, and Europe were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised a flexible regimen based on the angiotensin-converting-enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. The primary outcome was total stroke (fatal or non-fatal). Analysis was by intention to treat. Findings: Over 4 years of follow up, active treatment reduced blood pressure by 9/4 mm Hg. 307 (10%) individuals assigned active treatment suffered a stroke, compared with 420 (14%) assigned placebo (relative risk reduction 28% [95% CI 17-38], p

Original languageEnglish (US)
Pages (from-to)1033-1041
Number of pages9
JournalThe Lancet
Volume358
Issue number9287
DOIs
StatePublished - Sep 29 2001
Externally publishedYes

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Perindopril
Transient Ischemic Attack
Stroke
Blood Pressure
Placebos
Indapamide
Australasia
Therapeutics
Cerebrovascular Disorders
Intention to Treat Analysis
Risk Reduction Behavior
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Uncertainty
Physicians
Safety

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. / MacMahon, S.; Neal, B.; Tzourio, C.; Rodgers, A.; Woodward, M.; Cutler, J.; Anderson, C.; Chalmers, J.; Ohkubo, T.; Bouser, M. G.; Davis, S.; Donnan, G.; Hansson, L.; Harrap, S.; Lees, K. R.; Liu, L.; Mancia, G.; Neal, B.; Omae, T.; Reid, J.; Rodgers, A.; Sega, R.; Terent, A.; Tzourio, C.; Warlow, C.; Woodward, M.; Anderson, N.; Bladin, C.; Chambers, B.; Gordon, G.; Sharpe, N.; Collins, R.; Sandercock, P.; Simes, J.; Sleight, P.; Brnabic, A.; Colman, S.; Francis, L.; Lee, A.; Gong, L.; Bousser, M. G.; Yamaguchi, T.; Lees, K. R.; William, F.; Deng, Q.; Hu, D. X.; Wang, W.; Wu, A. L.; Ma, L. Y.; Tao, Z. Y.; Biousse, V.; Berthet, K.; Ben Slamia, L.; Le Denmat, C.; Crespi, S.; Foglia, G.; Fujimoto, C.; Matsumura, S.; Marttala, K.; Pettersson, M.; Safwenberg, M.; Fenton, J.; McIlvenna, Y.; Currie, R.; Bartram, H.; Briad, J.; Clague, A.; Cleverly, Y.; Cosson, M.; Culpan, A.; Douglas, D.; Flett, S.; Gray, B.; Holloway, T.; Milne, A.; Prasad, R.; Ratnasabapathy, Y.; Santos, A.; Wills, M.; Agnew, T.; Chapman, N.; Lewis, N.; Mullane, B.

In: The Lancet, Vol. 358, No. 9287, 29.09.2001, p. 1033-1041.

Research output: Contribution to journalArticle

MacMahon, S, Neal, B, Tzourio, C, Rodgers, A, Woodward, M, Cutler, J, Anderson, C, Chalmers, J, Ohkubo, T, Bouser, MG, Davis, S, Donnan, G, Hansson, L, Harrap, S, Lees, KR, Liu, L, Mancia, G, Neal, B, Omae, T, Reid, J, Rodgers, A, Sega, R, Terent, A, Tzourio, C, Warlow, C, Woodward, M, Anderson, N, Bladin, C, Chambers, B, Gordon, G, Sharpe, N, Collins, R, Sandercock, P, Simes, J, Sleight, P, Brnabic, A, Colman, S, Francis, L, Lee, A, Gong, L, Bousser, MG, Yamaguchi, T, Lees, KR, William, F, Deng, Q, Hu, DX, Wang, W, Wu, AL, Ma, LY, Tao, ZY, Biousse, V, Berthet, K, Ben Slamia, L, Le Denmat, C, Crespi, S, Foglia, G, Fujimoto, C, Matsumura, S, Marttala, K, Pettersson, M, Safwenberg, M, Fenton, J, McIlvenna, Y, Currie, R, Bartram, H, Briad, J, Clague, A, Cleverly, Y, Cosson, M, Culpan, A, Douglas, D, Flett, S, Gray, B, Holloway, T, Milne, A, Prasad, R, Ratnasabapathy, Y, Santos, A, Wills, M, Agnew, T, Chapman, N, Lewis, N & Mullane, B 2001, 'Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack', The Lancet, vol. 358, no. 9287, pp. 1033-1041. https://doi.org/10.1016/S0140-6736(01)06178-5
MacMahon, S. ; Neal, B. ; Tzourio, C. ; Rodgers, A. ; Woodward, M. ; Cutler, J. ; Anderson, C. ; Chalmers, J. ; Ohkubo, T. ; Bouser, M. G. ; Davis, S. ; Donnan, G. ; Hansson, L. ; Harrap, S. ; Lees, K. R. ; Liu, L. ; Mancia, G. ; Neal, B. ; Omae, T. ; Reid, J. ; Rodgers, A. ; Sega, R. ; Terent, A. ; Tzourio, C. ; Warlow, C. ; Woodward, M. ; Anderson, N. ; Bladin, C. ; Chambers, B. ; Gordon, G. ; Sharpe, N. ; Collins, R. ; Sandercock, P. ; Simes, J. ; Sleight, P. ; Brnabic, A. ; Colman, S. ; Francis, L. ; Lee, A. ; Gong, L. ; Bousser, M. G. ; Yamaguchi, T. ; Lees, K. R. ; William, F. ; Deng, Q. ; Hu, D. X. ; Wang, W. ; Wu, A. L. ; Ma, L. Y. ; Tao, Z. Y. ; Biousse, V. ; Berthet, K. ; Ben Slamia, L. ; Le Denmat, C. ; Crespi, S. ; Foglia, G. ; Fujimoto, C. ; Matsumura, S. ; Marttala, K. ; Pettersson, M. ; Safwenberg, M. ; Fenton, J. ; McIlvenna, Y. ; Currie, R. ; Bartram, H. ; Briad, J. ; Clague, A. ; Cleverly, Y. ; Cosson, M. ; Culpan, A. ; Douglas, D. ; Flett, S. ; Gray, B. ; Holloway, T. ; Milne, A. ; Prasad, R. ; Ratnasabapathy, Y. ; Santos, A. ; Wills, M. ; Agnew, T. ; Chapman, N. ; Lewis, N. ; Mullane, B. / Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. In: The Lancet. 2001 ; Vol. 358, No. 9287. pp. 1033-1041.
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T1 - Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack

AU - MacMahon, S.

AU - Neal, B.

AU - Tzourio, C.

AU - Rodgers, A.

AU - Woodward, M.

AU - Cutler, J.

AU - Anderson, C.

AU - Chalmers, J.

AU - Ohkubo, T.

AU - Bouser, M. G.

AU - Davis, S.

AU - Donnan, G.

AU - Hansson, L.

AU - Harrap, S.

AU - Lees, K. R.

AU - Liu, L.

AU - Mancia, G.

AU - Neal, B.

AU - Omae, T.

AU - Reid, J.

AU - Rodgers, A.

AU - Sega, R.

AU - Terent, A.

AU - Tzourio, C.

AU - Warlow, C.

AU - Woodward, M.

AU - Anderson, N.

AU - Bladin, C.

AU - Chambers, B.

AU - Gordon, G.

AU - Sharpe, N.

AU - Collins, R.

AU - Sandercock, P.

AU - Simes, J.

AU - Sleight, P.

AU - Brnabic, A.

AU - Colman, S.

AU - Francis, L.

AU - Lee, A.

AU - Gong, L.

AU - Bousser, M. G.

AU - Yamaguchi, T.

AU - Lees, K. R.

AU - William, F.

AU - Deng, Q.

AU - Hu, D. X.

AU - Wang, W.

AU - Wu, A. L.

AU - Ma, L. Y.

AU - Tao, Z. Y.

AU - Biousse, V.

AU - Berthet, K.

AU - Ben Slamia, L.

AU - Le Denmat, C.

AU - Crespi, S.

AU - Foglia, G.

AU - Fujimoto, C.

AU - Matsumura, S.

AU - Marttala, K.

AU - Pettersson, M.

AU - Safwenberg, M.

AU - Fenton, J.

AU - McIlvenna, Y.

AU - Currie, R.

AU - Bartram, H.

AU - Briad, J.

AU - Clague, A.

AU - Cleverly, Y.

AU - Cosson, M.

AU - Culpan, A.

AU - Douglas, D.

AU - Flett, S.

AU - Gray, B.

AU - Holloway, T.

AU - Milne, A.

AU - Prasad, R.

AU - Ratnasabapathy, Y.

AU - Santos, A.

AU - Wills, M.

AU - Agnew, T.

AU - Chapman, N.

AU - Lewis, N.

AU - Mullane, B.

PY - 2001/9/29

Y1 - 2001/9/29

N2 - Background: Blood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack. Methods: 6105 individuals from 172 centres in Asia, Australasia, and Europe were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised a flexible regimen based on the angiotensin-converting-enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. The primary outcome was total stroke (fatal or non-fatal). Analysis was by intention to treat. Findings: Over 4 years of follow up, active treatment reduced blood pressure by 9/4 mm Hg. 307 (10%) individuals assigned active treatment suffered a stroke, compared with 420 (14%) assigned placebo (relative risk reduction 28% [95% CI 17-38], p

AB - Background: Blood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack. Methods: 6105 individuals from 172 centres in Asia, Australasia, and Europe were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised a flexible regimen based on the angiotensin-converting-enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. The primary outcome was total stroke (fatal or non-fatal). Analysis was by intention to treat. Findings: Over 4 years of follow up, active treatment reduced blood pressure by 9/4 mm Hg. 307 (10%) individuals assigned active treatment suffered a stroke, compared with 420 (14%) assigned placebo (relative risk reduction 28% [95% CI 17-38], p

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