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Global impact of stroke.

¹Department of Medicine, University of Sydney, Sydney, Australia.

Heart Disease (Hagerstown, Md.)

|December 1, 2001

Summary

This summary is machine-generated.

Blood-pressure lowering significantly reduces stroke risk in patients with a history of stroke or transient ischemic attack (TIA). The PROGRESS trial provides definitive evidence for this crucial cardiovascular protective effect.

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Area of Science:

Cardiovascular Medicine
Neurology
Clinical Trials

Background:

Rising industrialization and urbanization increase cardiovascular disease and stroke risk globally.
Observational studies and prior trials link high blood pressure to stroke incidence and show potential benefit from antihypertensive therapy.
Previous trials on blood-pressure lowering in cerebrovascular disease patients were small and inconclusive.

Purpose of the Study:

To definitively determine the effect of blood-pressure lowering on stroke incidence in patients with a history of stroke or transient ischemic attack (TIA).
To evaluate the impact of perindopril (plus indapamide) versus placebo on secondary stroke prevention.

Main Methods:

The PROGRESS trial is a large, randomized, double-blind, controlled study.

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6,105 patients with a history of stroke or TIA were randomized to perindopril (plus indapamide) or placebo.

Mean follow-up exceeds 30 months, with a planned total of at least 4 years.

Main Results:

The trial is powered to achieve its primary objectives based on current event rates and adherence.
Secondary outcomes include myocardial infarction, cognitive decline, and dementia.

Conclusions:

Blood-pressure lowering is expected to significantly reduce stroke incidence in patients with prior cerebrovascular events.
The PROGRESS trial provides robust evidence for secondary stroke prevention strategies.