Perindopril-based blood pressure lowering reduces major vascular events in Asian and Western participants with cerebrovascular disease: the PROGRESS trial
Identifieur interne : 003724 ( PascalFrancis/Curation ); précédent : 003723; suivant : 003725Perindopril-based blood pressure lowering reduces major vascular events in Asian and Western participants with cerebrovascular disease: the PROGRESS trial
Auteurs : Hisatomi Arima [Australie] ; Craig Anderson [Australie] ; Teruo Omae [Japon] ; LISHENG LIU [République populaire de Chine] ; Christophe Tzourio [France] ; Mark Woodward [États-Unis] ; Stephen Macmahon [Australie] ; Bruce Neal [Australie] ; Anthony Rodgers [Australie] ; John Chalmers [Australie]Source :
- Journal of hypertension [ 0263-6352 ] ; 2010.
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- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Objective To assess the benefits of blood pressure (BP) lowering on vascular events separately for Asian and for Western participants with particular emphasis on stroke subtypes and cardiac outcomes. Methods This is a subsidiary analysis of Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a randomized, placebo-controlled trial that established the benefits of BP lowering in 6105 patients with cerebrovascular disease, randomly assigned to either active treatment (perindopril for all, and indapamide for those with neither an indication for, nor a contraindication to, a diuretic) or placebo(s). Outcomes are total and cause-specific vascular outcomes. Results The annual rates for total major vascular events were 4.2% in Asian and 5.2% in Western participants. Overall stroke rates were greater in Asian compared to Western participants with proportionally more lacunar infarctions and haemorrhagic strokes in Asians and more cardio-embolic infarctions and large artery infarctions in Western participants. Active treatment reduced BP by 10.3/ 4.6 mmHg in Asian, and by 8.1/3.6 mmHg in Western participants. Among Asian participants there was a 38% [95% confidence interval (CI) 23-49%] reduction in major vascular events compared to a 20% (95% CI 7-31%) reduction in Western participants (P homogeneity = 0.06). Similarly, there were higher relative risk reductions for all other outcomes among Asian participants, but this only reached statistical significance for heart failure and vascular death (P= 0.02 for each). The number needed to treat for major vascular events over 5 years was 15 (95% CI 10-26) in Asian compared to 28 (95% CI 17-94) in Western participants (P homogeneity = 0.09). Conclusions BP lowering reduces the risk of major vascular events, with separately significant reductions, in both Asia and the West.
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<series><title level="j" type="main">Journal of hypertension</title>
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<front><div type="abstract" xml:lang="en">Objective To assess the benefits of blood pressure (BP) lowering on vascular events separately for Asian and for Western participants with particular emphasis on stroke subtypes and cardiac outcomes. Methods This is a subsidiary analysis of Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a randomized, placebo-controlled trial that established the benefits of BP lowering in 6105 patients with cerebrovascular disease, randomly assigned to either active treatment (perindopril for all, and indapamide for those with neither an indication for, nor a contraindication to, a diuretic) or placebo(s). Outcomes are total and cause-specific vascular outcomes. Results The annual rates for total major vascular events were 4.2% in Asian and 5.2% in Western participants. Overall stroke rates were greater in Asian compared to Western participants with proportionally more lacunar infarctions and haemorrhagic strokes in Asians and more cardio-embolic infarctions and large artery infarctions in Western participants. Active treatment reduced BP by 10.3/ 4.6 mmHg in Asian, and by 8.1/3.6 mmHg in Western participants. Among Asian participants there was a 38% [95% confidence interval (CI) 23-49%] reduction in major vascular events compared to a 20% (95% CI 7-31%) reduction in Western participants (P homogeneity = 0.06). Similarly, there were higher relative risk reductions for all other outcomes among Asian participants, but this only reached statistical significance for heart failure and vascular death (P= 0.02 for each). The number needed to treat for major vascular events over 5 years was 15 (95% CI 10-26) in Asian compared to 28 (95% CI 17-94) in Western participants (P homogeneity = 0.09). Conclusions BP lowering reduces the risk of major vascular events, with separately significant reductions, in both Asia and the West.</div>
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<s2>NK</s2>
<s2>FR</s2>
<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Perindopril</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>09</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Pression artérielle</s0>
<s5>10</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Arterial pressure</s0>
<s5>10</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Presión arterial</s0>
<s5>10</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Pression sanguine</s0>
<s5>11</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Blood pressure</s0>
<s5>11</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Presión sanguínea</s0>
<s5>11</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Indapamide</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>12</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Indapamide</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>12</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Indapamida</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>12</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Hypertension artérielle</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Hypertension</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Hipertensión arterial</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Antihypertenseur</s0>
<s5>78</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Antihypertensive agent</s0>
<s5>78</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Antihipertensivo</s0>
<s5>78</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Diurétique</s0>
<s5>79</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Diuretic</s0>
<s5>79</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Diurético</s0>
<s5>79</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Inhibiteur angiotensin converting enzyme</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>ACE inhibitor</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Inhibidor angiotensin converting enzyme</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Inhibiteur enzyme</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Enzyme inhibitor</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Inhibidor enzima</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Peptidyl-dipeptidase A</s0>
<s2>FE</s2>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Peptidyl-dipeptidase A</s0>
<s2>FE</s2>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Peptidyl-dipeptidase A</s0>
<s2>FE</s2>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Peptidyl-dipeptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Peptidyl-dipeptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Peptidyl-dipeptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Peptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Peptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Peptidases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Enzyme</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Enzyme</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Enzima</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0>
<s5>40</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Cerebral disorder</s0>
<s5>40</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0>
<s5>41</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0>
<s5>42</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG"><s0>Nervous system diseases</s0>
<s5>42</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA"><s0>Sistema nervioso patología</s0>
<s5>42</s5>
</fC07>
<fC07 i1="11" i2="X" l="FRE"><s0>Dérivé de l'indole</s0>
<s5>43</s5>
</fC07>
<fC07 i1="11" i2="X" l="ENG"><s0>Indole derivatives</s0>
<s5>43</s5>
</fC07>
<fC07 i1="11" i2="X" l="SPA"><s0>Indol derivado</s0>
<s5>43</s5>
</fC07>
<fC07 i1="12" i2="X" l="FRE"><s0>Sulfamides</s0>
<s5>44</s5>
</fC07>
<fC07 i1="12" i2="X" l="ENG"><s0>Sulfonamides</s0>
<s5>44</s5>
</fC07>
<fC07 i1="12" i2="X" l="SPA"><s0>Sulfamidas</s0>
<s5>44</s5>
</fC07>
<fC07 i1="13" i2="X" l="FRE"><s0>Thiazide</s0>
<s5>45</s5>
</fC07>
<fC07 i1="13" i2="X" l="ENG"><s0>Thiazide</s0>
<s5>45</s5>
</fC07>
<fC07 i1="13" i2="X" l="SPA"><s0>Tiazida</s0>
<s5>45</s5>
</fC07>
<fC07 i1="14" i2="X" l="FRE"><s0>Pathologie des vaisseaux sanguins</s0>
<s5>46</s5>
</fC07>
<fC07 i1="14" i2="X" l="ENG"><s0>Vascular disease</s0>
<s5>46</s5>
</fC07>
<fC07 i1="14" i2="X" l="SPA"><s0>Vaso sanguíneo patología</s0>
<s5>46</s5>
</fC07>
<fN21><s1>067</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>
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