Perindopril Protection Against Recurrent Stroke Study - PROGRESS

Aims

To determine the effects of an angiotensin converting enzyme (ACE) inhibitor-based blood pressure lowering regimen on the risk of stroke among patients with a history of cerebrovascular disease. Secondary aims include investigation of the effects of treatment on other major outcomes and investigation of the cause of stroke.

Methods

PROGRESS was a randomised, double-blind, placebo-controlled trial in which 6,105 participants with stroke or transient ischemic attack were randomised to perindopril-based treatment or matching placebo(s). Follow-up continued for an average of four years.

Status/Results

The study is now complete and the main results show that study treatment reduced the risk of stroke by a quarter. The results have direct clinical implications for more than 50 million individuals with cerebrovascular disease worldwide.

Many further papers documenting the effects of treatment on major secondary outcomes, such as cardiac endpoints, disability and dementia, have now been published as well as papers reporting substudies or sub group analyses.

The current activity is focusing on analyses of biochemical markers in baseline blood samples (PROGRESS Blood Samples Study) that may predict the incidence of vascular complication during follow-up, on economic analysis of PROGRESS, and on stroke subtypes.

Treatment with ACE inhibitors and diuretics or with Perindopril and Indapamide specifically, is now recommended by the major international guidelines for the treatment of hypertension, including the JNC7 (7th Report of the Joint National Committee in the USA), WHO-ISH (World Health Organisation-International Society of Hypertension), European and Australian Guidelines. This treatment is also recommended in the major guidelines for the treatment of patients with stroke.

Publications

PROGRESS Publications List

Institute Investigators

Project Manager

  • Rochelle Currie

Collaboration

Funding Agencies