A familiar drug may have previously unrealized benefits for stroke patients. Results from a landmark six year study of more than 6,000 patients were presented at the European Society of Hypertension (ESH) Congress meeting in Milan earlier this year. The study, 'PROGRESS' (Perinodopril prOtection aGainst REcurrent Stroke Study), was designed to provide evidence regarding the balance of benefits and risks conferred by blood pressure lowering with a perindopril (Coversyl) based regimen among patients with a history of stroke or transient ischemic attack (TIA).
Fifty-eight percent of patients in the study were given perindopril (4 mg) and the diuretic indapamide (Lozide) (2.5 mg) or a placebo daily, and the remaining patients were given perindopril (4 mg) alone or a placebo daily. Participants in the study were free to take any other medications prescribed by their physicians, including other hypertension medications.
Results showed that the ACE inhibitor, perindopril, reduces the incidence of recurrent stroke by 28% compared to placebo; this decrease in stroke rates was seen in both hypertensive and normotensive patients. After an average follow-up of four years, the treatment groups had 50% fewer hemorrhagic strokes overall and 24% fewer ischemic strokes than did the placebo group. In addition, rates of non-fatal MI and dementia due to stroke were both reduced by 38% and 34% respectively in the treatment groups when compared to placebo. Severe cognitive decline due to stroke was reduced by 45%.
World health statistics indicate that about five million people die from stroke every year and at least 15 million others suffer non-fatal strokes that are frequently disabling. About one in five survivors will suffer another stroke or heart attack within five years.
