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Combined treatment with indapamide and perindopril but not perindopril alone reduced the risk for recurrent stroke

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 QUESTION: In patients with a history of stroke or transient ischaemic attack (TIA), is perindopril alone or combined with indapamide more effective than placebo for reducing fatal or non-fatal stroke?


Two* randomised (allocation concealed), blinded {patients, clinicians, data collectors, outcome assessors, data analysts, and manuscript writers}, placebo controlled trials with a mean follow up of 3.9 years (Perindopril Protection against Recurrent Stroke Study [PROGRESS]).


172 centres from 10 countries.


6105 patients (mean age 64 y, 70% men) who had a history of stroke or TIA in the previous 5 years, had no definite indication for or contraindication to an angiotensin-converting enzyme (ACE) inhibitor, and were clinically stable for ≥ 2 weeks after their most recent vascular event. 6102 patients (> 99%) completed follow up for fatal events.


Some patients were …

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  • * The authors disagree with our reporting of their study as 2 separate trials.

  • See glossary.

  • Information provided by author.

  • Sources of funding: Servier Pharmaceuticals; Health Research Council of New Zealand; National Health and Medical Research Council of Australia.

  • For correspondence: not available.