Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy: The PROGRESS Trial
Identifieur interne : 007911 ( Main/Exploration ); précédent : 007910; suivant : 007912Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy: The PROGRESS Trial
Auteurs : Hisatomi Arima [Australie] ; Christophe Tzourio [France] ; Craig Anderson [Australie] ; Mark Woodward [États-Unis] ; Marie-Germaine Bousser [France] ; Stephen Macmahon [Australie] ; Bruce Neal [Australie] ; John Chalmers [Australie]Source :
- Stroke : (1970) [ 0039-2499 ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background and Purpose-Patients with cerebral amyloid angiopathy (CAA) are at high risk for intracerebral hemorrhage (ICH), but no effective prevention strategies have been established. The objective is to determine whether lowering of blood pressure (BP) provides protection for this high-risk patient group. Methods-This study is a subsidiary analysis of the PROGRESS trial-a randomized, placebo-controlled trial that established the beneficial effects of BP lowering in patients with cerebrovascular disease; 6105 patients were randomly assigned to either active treatment (perindopril for all participants plus indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo. Outcomes were probable CAA-related ICH as defined by the Boston criteria, probable hypertension-related ICH, and unclassified ICH. Results-Over a mean follow-up of 3.9 years, 16 probable CAA-related ICH, 51 probable hypertension-related ICH, and 44 unclassified ICH occurred. Active treatment reduced the risk of CAA-related ICH by 77% (95% CI, 19%-93%), that of hypertension-related ICH by 46% (95% CI, 4%-69%), and that of unclassified ICH by 43% (95% CI, -5%-69%). There was no evidence of differences in the magnitude of the effects of treatment among different types of ICH (P homogeneity=0.4). Conclusions-BP-lowering treatment is likely to provide protection against all types of ICH.
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last="Arima">Hisatomi Arima</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The George Institute for International Health, the University of Sydney and the Royal Prince Alfred Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Tzourio, Christophe" sort="Tzourio, Christophe" uniqKey="Tzourio C" first="Christophe" last="Tzourio">Christophe Tzourio</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>INSERM U708</s1><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>INSERM U708</wicri:noRegion><wicri:noRegion>INSERM U708</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Neurology, Hôpital Lariboisière</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The George Institute for International Health, the University of Sydney and the Royal Prince Alfred Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Mount Sinai School of Medicine</s1><s2>New York, NY</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mount Sinai School of Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Bousser, Marie Germaine" sort="Bousser, Marie Germaine" uniqKey="Bousser M" first="Marie-Germaine" last="Bousser">Marie-Germaine Bousser</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Neurology, Hôpital Lariboisière</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The George Institute for International Health, the University of Sydney and the Royal Prince Alfred Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Neal, Bruce" sort="Neal, Bruce" uniqKey="Neal B" first="Bruce" last="Neal">Bruce Neal</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The George Institute for International Health, the University of Sydney and the Royal Prince Alfred Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>The George Institute for International Health, the University of Sydney and the Royal Prince Alfred Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Stroke : (1970)</title><title level="j" type="abbreviated">Stroke : (1970)</title><idno type="ISSN">0039-2499</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antihypertensive agent</term><term>Arterial pressure</term><term>Blood pressure</term><term>Cerebral amyloid angiopathy</term><term>Cerebral hemorrhage</term><term>Cerebrovascular disease</term><term>Nervous system diseases</term><term>Perindopril</term><term>Stroke</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hémorragie cérébrale</term><term>Angiopathie amyloïde cérébrale</term><term>Pathologie du système nerveux</term><term>Pathologie cérébrovasculaire</term><term>Accident cérébrovasculaire</term><term>Périndopril</term><term>Pression artérielle</term><term>Pression sanguine</term><term>Antihypertenseur</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and Purpose-Patients with cerebral amyloid angiopathy (CAA) are at high risk for intracerebral hemorrhage (ICH), but no effective prevention strategies have been established. The objective is to determine whether lowering of blood pressure (BP) provides protection for this high-risk patient group. Methods-This study is a subsidiary analysis of the PROGRESS trial-a randomized, placebo-controlled trial that established the beneficial effects of BP lowering in patients with cerebrovascular disease; 6105 patients were randomly assigned to either active treatment (perindopril for all participants plus indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo. Outcomes were probable CAA-related ICH as defined by the Boston criteria, probable hypertension-related ICH, and unclassified ICH. Results-Over a mean follow-up of 3.9 years, 16 probable CAA-related ICH, 51 probable hypertension-related ICH, and 44 unclassified ICH occurred. Active treatment reduced the risk of CAA-related ICH by 77% (95% CI, 19%-93%), that of hypertension-related ICH by 46% (95% CI, 4%-69%), and that of unclassified ICH by 43% (95% CI, -5%-69%). There was no evidence of differences in the magnitude of the effects of treatment among different types of ICH (P homogeneity=0.4). Conclusions-BP-lowering treatment is likely to provide protection against all types of ICH.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>États-Unis</li></country><region><li>Nouvelle-Galles du Sud</li><li>Île-de-France</li></region><settlement><li>Paris</li><li>Sydney</li></settlement></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Arima, Hisatomi" sort="Arima, Hisatomi" uniqKey="Arima H" first="Hisatomi" last="Arima">Hisatomi Arima</name></region><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name><name sortKey="Neal, Bruce" sort="Neal, Bruce" uniqKey="Neal B" first="Bruce" last="Neal">Bruce Neal</name></country><country name="France"><noRegion><name sortKey="Tzourio, Christophe" sort="Tzourio, Christophe" uniqKey="Tzourio C" first="Christophe" last="Tzourio">Christophe Tzourio</name></noRegion><name sortKey="Bousser, Marie Germaine" sort="Bousser, Marie Germaine" uniqKey="Bousser M" first="Marie-Germaine" last="Bousser">Marie-Germaine Bousser</name><name sortKey="Tzourio, Christophe" sort="Tzourio, Christophe" uniqKey="Tzourio C" first="Christophe" last="Tzourio">Christophe Tzourio</name></country><country name="États-Unis"><noRegion><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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