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Recurrent Stroke Prevention I: Diuretic and Angiotensin-Converting Enzyme Inhibitors (ACEIs) – The PROGRESS Trial

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Hypertension and Stroke

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

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Abstract

The rationale and design of the Perindopril Protection Against Secondary Stroke Study (PROGRESS) was published in 1996 (1), while recruitment had already commenced in 1995. The study design involved a randomized, double-blind, placebo-controlled trial approach in which the blood pressure-lowering component was the angiotensin-converting enzyme inhibiting agent perindopril with and without the addition of the thiazide diuretic indapamide. The primary outcome measure was recurrent stroke of all types (fatal, nonfatal, ischaemic and hemorrhagic). The total sample size was over 7,000 patients from almost 200 centres in ten countries worldwide with a follow up of a mean 4 years. The major findings were published in 2001. PROGRESS was the first study to show definitively that ACEI-based blood pressure-lowering regimens reduced the risk of recurrent stroke. This was particularly for haemorrhagic stroke and, importantly, was independent of baseline blood pressure. In other words, the benefits were not only for hypertensive patients, but for all participants.

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Author information

Authors and Affiliations

  1. Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden

    Thomas K.A. Linden MD, PhD

  2. National Stroke Research Institute, Heidelberg Heights, VIC, Australia

    Thomas K.A. Linden MD, PhD

  3. The Florey Neuroscience Institutes, University of Melbourne, Melbourne, VIC, Australia

    Geoffrey A. Donnan MD, FRCP, FRACP

Authors
  1. Thomas K.A. Linden MD, PhD
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  2. Geoffrey A. Donnan MD, FRCP, FRACP
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Correspondence to Thomas K.A. Linden MD, PhD .

Editor information

Editors and Affiliations

  1. College of Medicine, Dept. Neurology, University of Illinois, 912 S. Wood Street Room 855 N, Chicago, 60612, Illinois, USA

    Venkatesh Aiyagari

  2. University of Illinois, Department of Neurology and Rehabilitati, College of Medicine at Chicago, S. Wood St 912, Chicago, 60612, Illinois, USA

    Philip B. Gorelick

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Linden, T.K., Donnan, G.A. (2011). Recurrent Stroke Prevention I: Diuretic and Angiotensin-Converting Enzyme Inhibitors (ACEIs) – The PROGRESS Trial. In: Aiyagari, V., Gorelick, P. (eds) Hypertension and Stroke. Clinical Hypertension and Vascular Diseases. Humana Press. https://doi.org/10.1007/978-1-60761-010-6_9

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  • DOI: https://doi.org/10.1007/978-1-60761-010-6_9

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  • Online ISBN: 978-1-60761-010-6

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