The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease: A combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials

Jasper J. Brugts, Toshiharu Ninomiya, Eric Boersma, Willem J. Remme, Michel Bertrand, Roberto Ferrari, Kim Fox, Stephen MacMahon, John Chalmers, Maarten L. Simoons

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

AimsAngiotensin-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 resultsWe 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.ConclusionThis 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.

Original languageEnglish
Pages (from-to)1385-1394
Number of pages10
JournalEuropean heart journal
Volume30
Issue number11
DOIs
Publication statusPublished - Jun 1 2009
Externally publishedYes

Fingerprint

Perindopril
Enzyme Inhibitors
Vascular Diseases
Confidence Intervals
Mortality
Indapamide
Therapeutics
Heart Failure
Stroke
Myocardial Infarction
Placebos
Blood Pressure
Survival

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease : A combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials. / Brugts, Jasper J.; Ninomiya, Toshiharu; Boersma, Eric; Remme, Willem J.; Bertrand, Michel; Ferrari, Roberto; Fox, Kim; MacMahon, Stephen; Chalmers, John; Simoons, Maarten L.

In: European heart journal, Vol. 30, No. 11, 01.06.2009, p. 1385-1394.

Research output: Contribution to journalArticle

Brugts, Jasper J. ; Ninomiya, Toshiharu ; Boersma, Eric ; Remme, Willem J. ; Bertrand, Michel ; Ferrari, Roberto ; Fox, Kim ; MacMahon, Stephen ; Chalmers, John ; Simoons, Maarten L. / The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease : A combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials. In: European heart journal. 2009 ; Vol. 30, No. 11. pp. 1385-1394.
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T1 - The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease

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AU - Brugts, Jasper J.

AU - Ninomiya, Toshiharu

AU - Boersma, Eric

AU - Remme, Willem J.

AU - Bertrand, Michel

AU - Ferrari, Roberto

AU - Fox, Kim

AU - MacMahon, Stephen

AU - Chalmers, John

AU - Simoons, Maarten L.

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N2 - AimsAngiotensin-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 resultsWe 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.ConclusionThis 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.

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