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Reductions in the risks of recurrent stroke in patients with and without diabetes: the PROGRESS Trial

Karine Berthet1, Bruce C Neal, John P Chalmers

  • 1Department of Neurology, Lariboisiere Hospital, Paris, France.

Blood Pressure
|April 16, 2004
PubMed

Insights

Diabetes significantly increases stroke risk in patients with cerebrovascular disease. Perindopril-based treatment effectively reduces recurrent stroke risk in diabetic patients, comparable to non-diabetic individuals.

Area of Science:

  • Neurology
  • Cardiology
  • Endocrinology

Background:

  • Stroke and transient ischaemic attack (TIA) patients were analyzed for stroke risk.
  • The study involved 6105 participants in a randomized, double-blind, placebo-controlled trial.
  • A perindopril-based blood pressure lowering regimen was investigated over a median follow-up of 3.9 years.

Purpose of the Study:

  • To assess the impact of diabetes on stroke risk in patients with established cerebrovascular disease.
  • To evaluate the efficacy of a perindopril-based regimen in reducing recurrent stroke risk in diabetic and non-diabetic patients.
  • To compare the effectiveness of blood pressure lowering treatment in patients with and without diabetes.

Main Methods:

  • Randomized, double-blind, placebo-controlled trial design.
  • Inclusion of 6105 patients with prior stroke or TIA.
  • Analysis of stroke risk and treatment outcomes stratified by diabetes status at baseline.

Main Results:

  • Diabetes elevated the risk of recurrent stroke by 35%, primarily affecting ischaemic stroke.
  • Perindopril-based treatment reduced blood pressure by approximately 9.5/4.6 mmHg in diabetic patients and 8.9/3.9 mmHg in non-diabetic patients.
  • Proportional risk reductions for stroke were 38% in diabetic patients and 28% in non-diabetic patients, with no significant difference between groups (p=0.5).

Conclusions:

  • Diabetes is a significant risk factor for stroke recurrence in patients with cerebrovascular disease.
  • Perindopril-based treatment, including indapamide, effectively reduces recurrent stroke risk in diabetic patients.
  • Treatment benefits in diabetic patients were comparable to those observed in non-diabetic patients.
Abstract

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