Related Experiment Video

Updated: Jul 7, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Lower blood pressure and risk of recurrent stroke in patients with chronic kidney disease: PROGRESS trial

T Ninomiya1, V Perkovic, M Gallagher

  • 1George Institute for International Health, University of Sydney, Sydney, New South Wales, Australia.

Kidney International
|February 15, 2008
PubMed

Insights

Perindopril effectively lowers blood pressure (BP) to prevent recurrent stroke in chronic kidney disease (CKD) patients. This treatment shows benefits across various BP levels, without increasing stroke risk in those with low BP.

Area of Science:

  • Nephrology
  • Neurology
  • Cardiology

Background:

  • Epidemiological studies indicate a J-shaped relationship between systolic blood pressure (SBP) and stroke risk in chronic kidney disease (CKD) patients.
  • The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) trial showed perindopril-based blood pressure (BP) lowering reduced stroke risk in patients with prior cerebrovascular disease.

Purpose of the Study:

  • To evaluate the effect of perindopril-based BP lowering on recurrent stroke risk in CKD patients.
  • To examine the relationship between baseline BP, achieved follow-up BP, and stroke risk in this population.

Main Methods:

  • Analysis of 1757 participants with stage 3 or greater CKD from the PROGRESS trial.
  • Assessment of recurrent stroke risk based on baseline BP and achieved BP levels during follow-up.
  • Statistical analysis to determine the relationship between BP and stroke incidence, adjusting for confounders.

Main Results:

  • Perindopril-based therapy significantly reduced recurrent stroke risk across all baseline SBP levels.
  • A log-linear relationship was observed between achieved SBP and stroke incidence per 1000 person-years.
  • This association remained significant after adjusting for potential confounding factors.

Conclusions:

  • Perindopril-based BP lowering is effective in preventing recurrent stroke in patients with CKD.
  • The benefits extend across a wide range of BP levels.
  • No increased risk of stroke was observed in patients with low BP levels receiving treatment.

Related Concept Videos

Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...