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

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Book cover 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 (J Hypertens Suppl. 1996;14(6):S47–51), 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-like diuretic indapamide. The primary outcome measure was recurrent stroke of all types (fatal, nonfatal, ischaemic and hemorrhagic). The total sample size was over 7000 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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Authors and Affiliations

  1. Institute of Neuroscience and Physiology, Gothenburg University, Box 100, Gothenburg, 405 30, Sweden

    Thomas K. A. Linden M.D., Ph.D.

  2. The Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Melbourne, VIC, 3052, Australia

    Thomas K. A. Linden M.D., Ph.D. & Geoffrey A. Donnan M.D., F.R.C.P., F.R.A.C.P.

  3. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Thomas K. A. Linden M.D., Ph.D.

Authors
  1. Thomas K. A. Linden M.D., Ph.D.
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  2. Geoffrey A. Donnan M.D., F.R.C.P., F.R.A.C.P.
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Correspondence to Thomas K. A. Linden M.D., Ph.D. .

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Editors and Affiliations

  1. Departments of Neurological Surgery and Neurology and Neurotherapeutics , University of Texas Southwestern Medical Center , Dallas, Texas, USA

    Venkatesh Aiyagari

  2. Michigan State University Department of Translational Science & Molecular Medicine, Mercy Health Hauenstein Neurosciences, Grand Rapids, Michigan, USA

    Philip B. Gorelick

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Linden, T.K.A., Donnan, G.A. (2016). Recurrent Stroke Prevention: 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, Cham. https://doi.org/10.1007/978-3-319-29152-9_12

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  • DOI: https://doi.org/10.1007/978-3-319-29152-9_12

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-29150-5

  • Online ISBN: 978-3-319-29152-9

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