First ACE-Inhibitor Trial For Stroke Prevention

30 June 1996

Speaking at the 16th International Society of Hypertension meeting in Glasgow, Scotland on June 23, John Chalmers (Flinders Medical Center, Australia), and Stephen MacMahon (University of Auckland, New Zealand), announced the launch of the ISH-World Health Organization study, named PROGRESS - Perindopril Protection Against Recurrent Stroke Study.

French company Servier's Coversyl (perindopril) is an ACE-inhibitor drug used in the treatment of hypertension (Marketletters passim). Strokes affect many thousands of people each year. Although about two-thirds of strokes occur in non-hypertensives, an individual's blood pressure is known to be an important indicator of potential stroke. It is already known that treatment with antihypertensives to lower blood pressure may prevent the onset of primary stroke, but it is yet to be confirmed that it may lower the risk, or prevent stroke in individuals who already have a form of cerebrovascular disease, either cerebral infarction, cerebral hemorrhage, or transient ischemic attack. Previous studies have been inconclusive in this field, and PROGRESS aims to resolve this issue.

Clinical Trial Design Perindopril was chosen as the trial product because: it has no first-dose effect - an important consideration when hypotension is to be avoided; it has a good safety and efficacy profile over 24 hours for once-daily administration; it will not impair cerebral autoregulation, thus is the drug least likely to cause cerebral damage; and it has proved successful in treating both hypertensive and normotensive myocardial infarction patients.

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