Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

Aims

Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce cardiovascular risk in different groups of patients. Whether these effects can be generalized to the broad group of patients with vascular disease is unknown. Therefore, we undertook a combined analysis using individual data from ADVANCE, EUROPA, and PROGRESS to determine the consistency of the treatment effect of perindopril-based regimen in patients with vascular disease or at high risk of vascular disease.

Methods and results

We studied all-cause mortality and major cardiovascular outcomes during a follow-up of about 4 years in the 29 463 patients randomly assigned a perindopril-based treatment regimen or placebo. The perindopril-based regimens were associated with a significant reduction in all-cause mortality [hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.82–0.96; P = 0.006], cardiovascular mortality (HR 0.85; 95% CI 0.76–0.95; P = 0.004), non-fatal myocardial infarction (HR 0.80; 95% CI 0.71–0.90; P < 0.001), stroke (HR 0.82; 95% CI 0.74–0.92; P = 0.002), and heart failure (HR 0.84; 95% CI 0.72–0.96; P = 0.015). Results were consistent in subgroups with different clinical characteristics, concomitant medication use, and across all strata of baseline blood pressure.

Conclusion

This study provides strong evidence for a consistent cardiovascular protection with an ACE-inhibitor treatment regimen (perindopril–indapamide) by improving survival and reducing the risk of major cardiovascular events across a broad spectrum of patients with vascular disease.

Perindopril, Coronary artery disease, Diabetes, Stroke, Vascular disease, Prevention
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: [email protected]
Topic:
Issue Section:
Clinical Research > Prevention and epidemiology
You do not currently have access to this article.
Download all slides