Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy The PROGRESS Trial
Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy The PROGRESS Trial
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DOI：
10.1161/strokeaha.109.563932
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发表时间：
2010-02-01
期刊：
影响因子：
8.3
通讯作者：
Chalmers, John
中科院分区：
文献类型：
--
作者：
Arima, Hisatomi;Tzourio, Christophe;Chalmers, John
背景和目的：脑淀粉样血管病（CAA）患者是脑出血（ICH）的高危人群，但目前还没有有效的预防措施。目的是确定是否降低血压（BP）提供保护，为这一高风险的患者group. Methods-这项研究是一个附属分析的进展试验-一个随机，安慰剂对照试验，建立了有益的影响，血压降低脑血管疾病患者; 6105例患者被随机分配至任一活性治疗组（培哚普利用于所有受试者，吲达帕胺用于既无利尿剂适应症也无利尿剂禁忌症的受试者）或匹配安慰剂。结果可能CAA相关的ICH定义的波士顿标准，可能高血压相关的ICH，和未分类的ICH.Results-Over平均随访3.9年，16可能CAA相关的ICH，51可能高血压相关的ICH，和44未分类的ICH发生。积极治疗可使CAA相关ICH的风险降低77%（95% CI，19%-93%），使高血压相关ICH的风险降低46%（95% CI，4%-69%），使未分类ICH的风险降低43%（95% CI，-5%-69%）。没有证据表明不同类型的ICH（P同质性=0.4）之间的治疗效果的大小差异。结论-BP降低治疗可能对所有类型的ICH提供保护。（中风。2010; 41：394-396.）
Background and Purpose-Patients with cerebral amyloid angiopathy (CAA) are at high risk for intracerebral hemorrhage (ICH), but no effective prevention strategies have been established. The objective is to determine whether lowering of blood pressure (BP) provides protection for this high-risk patient group.Methods-This study is a subsidiary analysis of the PROGRESS trial-a randomized, placebo-controlled trial that established the beneficial effects of BP lowering in patients with cerebrovascular disease; 6105 patients were randomly assigned to either active treatment (perindopril for all participants plus indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo. Outcomes were probable CAA-related ICH as defined by the Boston criteria, probable hypertension-related ICH, and unclassified ICH.Results-Over a mean follow-up of 3.9 years, 16 probable CAA-related ICH, 51 probable hypertension-related ICH, and 44 unclassified ICH occurred. Active treatment reduced the risk of CAA-related ICH by 77% (95% CI, 19%-93%), that of hypertension-related ICH by 46% (95% CI, 4%-69%), and that of unclassified ICH by 43% (95% CI, -5%-69%). There was no evidence of differences in the magnitude of the effects of treatment among different types of ICH (P homogeneity=0.4).Conclusions-BP-lowering treatment is likely to provide protection against all types of ICH. ( Stroke. 2010; 41: 394-396.)