Effects of a perindopril-based blood pressure lowering regimen on cardiac outcomes among patients with cerebrovascular disease

Chaturvedi, V. et al. (2003) Effects of a perindopril-based blood pressure lowering regimen on cardiac outcomes among patients with cerebrovascular disease. European Heart Journal, 24(5), pp. 475-484. (doi: 10.1016/S0195-668X(02)00804-7)

Abstract

Aim: To determine the effects of a perindopril-based blood pressure lowering regimen on major cardiac events among hypertensive and non-hypertensive patients with a history of cerebrovascular disease. Methods and results: A total of 6105 individuals with a history of stroke or transient ischaemic attack were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised the angiotensin-converting-enzyme inhibitor perindopril (4mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. Over a mean of 3.9 years of follow-up, active treatment reduced blood pressure by 9/4mmHg compared with placebo and reduced the primary outcome, stroke, by 28%. Major coronary events occurred in 269 participants (active 3.8%, placebo 5.0%) and heart failure was diagnosed in 264 participants (active 3.7%, placebo 4.9%). Active treatment reduced the risk of major coronary events by 26% (95% CI: 6–42%; p=0.02) and the risk of congestive heart failure by 26% (5–42%; p=0.02). For each of these outcomes, there was no clear evidence of differences between the treatment effects in participants classified as hypertensive or non-hypertensive, and those with or without a history of coronary heart disease. Conclusions: Among individuals with cerebrovascular disease, blood pressure lowering with a regimen involving perindopril and indapamide not only reduced the risk of stroke, but also substantially reduced the risks of cardiac outcomes.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lees, Professor Kennedy and Woodward, Professor Mark
• Authors: Chaturvedi, V., Patel, A., Chalmers, J., Chapman, N., Hansson, L., MacMahon, S., Mancia, G., Neal, B., Reid, J., Sharpe, N., Woodward, M., Anderson, C., Bousser, M.G., Cutler, J., Davis, S., Donnan, G., Harrap, S., Lees, K.R., Liu, L., Omae, T., Rodgers, A., Sega, R., Terent, A., Tzourio, C., Warlow, C., Anderson, N., Bladin, C., Chambers, B., Gordon, G., Collins, R., Sandercock, P., Simes, J., Sleight, P., Coleman, S., and Lee, A.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences
• Journal Name: European Heart Journal
• ISSN: 0195-668X
• ISSN (Online): 1522-9645