BP-lowering treatment with perindopril decreases the likelihood of major vascular events and stroke in CKD patients with cerebrovascular disease.
The findings come from the Perindopril Protection against Recurrent Stroke (PROGRESS) study, which enrolled 6,105 patients with cerebrovascular disease. The patients were randomized to receive perindopril, an ACE inhibitor, or placebo.
The study, led by Vlado Perkovic, MD, of the George Institute for International Health at the University of Sydney, showed that patients with CKD were at about 1.5 times higher risk of major vascular events, stroke, and coronary heart disease compared with subjects who did not have CKD.
The probability of mortality was twice as likely. Perindopril-based therapy decreased the risk of major vascular events by 30% and stroke by 35%, the investigators reported in the Journal of the American Society of Nephrology (2007; published online ahead of print).
Among patients with CKD and a history of cerebrovascular disease, perindopril prevented one stroke or other cardiovascular event for every 11 patients treated over five years, the study showed.
Kidney function should be considered when determining the need for BP therapy in patients with cerebrovascular disease.