Evidence Based Medicine: Effects of a perindopril-based blood-pressure-lowering regimen in patients with previous stroke or transient ischaemic attack (progress). How do the results affect practice in Pakistan?

Why is this study important? Stroke is the leading cause of sustained disability worldwide. Contrary to popular belief, two thirds of stroke mortality will occur in the developing world in patients less than 70 years of age. Among those who survive a stroke or TIA, the risk of recurrent stroke is very high. Thus, broad interventions that decrease the risk of stroke are welcome in the developing world. Blood pressure had been recognized as an important determinant of the risk of initial stroke in several studies which had included both hypertensive as well as normotensive patients. However, the association between hypertension and stroke recurrence was not as clear from previous studies. The aim of this particular study was to determine the effects of a flexible blood pressure lowering regimen on the risk of stroke recurrence and other major vascular events in patients who had a history of stroke or Transient ischaemic attack. The patients were recruited regardless of their entry blood pressure levels.