Evidence map›Paper›PMID 11589932›Full record

Trial reportLancet (London, England)2001

Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack.

PROGRESS Collaborative Group

Erratum issued 2 registry-linked trialsAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 738 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
738citing papers in PubMed, 24 pooled it
114.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00108706 phase4unknown statusnot on this mapstarted 2004, after this paper: background citation

Acute Candesartan Cilexetil Outcomes Stroke Trial (ACCOST)

TypeinterventionalSponsorCity Hospitals Sunderland NHS Foundation TrustRan2004 to 2007Enrolled50ConditionsCerebrovascular Accident, Acute StrokeArmsCandesartan
NCT03738761 phase4completednot on this mapstarted 2018, after this paper: background citation

Fixed-Dose Combination of Perindopril/Amlodipine (Amlessa®) and Fixed-Dose Combination of Perindopril/Indapamide /Amlodipine (Co-Amlessa®) - Contribution to Management in Newly Diagnosed and Uncontrolled Hypertensive Patients

TypeinterventionalSponsorKRKARan2018 to 2019Enrolled471ConditionsHypertensionArmsAmlessa®, Co-Amlessa®
3 · Its place in the literature

Who cites it

738 citing papers in PubMed, 24 syntheses or guidelines pooled it, 3,168 citations in OpenAlex.

  1. Pooled it
  2. Pharmacotherapy for mild hypertension.The Cochrane database of systematic reviews · 2025
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  6. Guideline
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  12. Should we adjudicate outcomes in stroke trials? A systematic review.International journal of stroke : official journal of the International Stroke Society · 2023
    Pooled it
  13. Guideline
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  18. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019
    Guideline
  19. Pharmacotherapy for hypertension in adults 60 years or older.The Cochrane database of systematic reviews · 2019
    Pooled it
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678 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

PROGRESS Collaborative Group
University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood pressure is a determinant of the risk of stroke among both hypertensive and non-hypertensive individuals with cerebrovascular disease. However, there is uncertainty about the efficacy and safety of blood-pressure-lowering treatments for many such patients. The perindopril protection against recurrent stroke study (PROGRESS) was designed to determine the effects of a blood-pressure-lowering regimen in hypertensive and non-hypertensive patients with a history of stroke or transient ischaemic attack.

methods6105 individuals from 172 centres in Asia, Australasia, and Europe were randomly assigned active treatment (n=3051) or placebo (n=3054). Active treatment comprised a flexible regimen based on the angiotensin- converting-enzyme inhibitor perindopril (4 mg daily), with the addition of the diuretic indapamide at the discretion of treating physicians. The primary outcome was total stroke (fatal or non-fatal). Analysis was by intention to treat.

findingsOver 4 years of follow up, active treatment reduced blood pressure by 9/4 mm Hg. 307 (10%) individuals assigned active treatment suffered a stroke, compared with 420 (14%) assigned placebo (relative risk reduction 28% [95% CI 17-38], p<0.0001). Active treatment also reduced the risk of total major vascular events (26% [16-34]). There were similar reductions in the risk of stroke in hypertensive and non-hypertensive subgroups (all p<0.01). Combination therapy with perindopril plus indapamide reduced blood pressure by 12/5 mm Hg and stroke risk by 43% (30-54). Single-drug therapy reduced blood pressure by 5/3 mm Hg and produced no discernable reduction in the risk of stroke.

interpretationThis blood-pressure-lowering regimen reduced the risk of stroke among both hypertensive and non-hypertensive individuals with a history of stroke or transient ischaemic attack. Combination therapy with perindopril and indapamide produced larger blood pressure reductions and larger risk reductions than did single drug therapy with perindopril alone. Treatment with these two agents should now be considered routinely for patients with a history of stroke or transient ischaemic attack, irrespective of their blood pressure.

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsBlood PressureDiureticsDrug Therapy, CombinationFemaleHumansHypertensionIndapamideMaleMiddle AgedPerindoprilStrokeAngiotensin-Converting Enzyme InhibitorsDiureticsIndapamidePerindopril

Identifiers

PMID11589932
OpenAlexW1592471891

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.