The prevention of secondary stroke, cardiac outcomes and cognitive decline in patients with cerebrovascular disease: The PROGRESS trial

Individuals with a history of cerebrovascular disease have elevated risks of recurrent stroke, other cardiovascular events, and cognitive decline. In the Perindopril Protection Against Recurrent Stroke Study, 6,105 hypertensive and nonhypertensive individuals with a history of stroke or transient ischemic attack were randomly assigned active blood-pressure-lowering treatment (a flexible regimen that included perindopril and indapamide) or placebo. Over a mean follow-up period of 3.9 years, active treatment lowered the relative risks of stroke by 28%, major vascular events, major coronary events, and congestive heart failure each by 26%, and cognitive decline by 19%. The benefits observed were similar in those both with and without hypertension at baseline.