Why the study?
Does the combination of perindopril and indapamide reduce stroke, vascular death, and major cardiovascular events in patients at cardiovascular risk?
Does the combination of perindopril and indapamide reduce stroke, vascular death, and major cardiovascular events in patients at cardiovascular risk?
The fixed-dose combination of perindopril and indapamide significantly reduces vascular death and major cardiovascular events, though its effect on stroke reduction showed significant heterogeneity and requires further evaluation.
Supports perindopril-indapamide for lowering vascular death and MACE in at-risk patients; extends meta-analytic evidence for fixed-dose ACEI-diuretic combinations.
Perindopril/indapamide combination has been shown to reduce cardiovascular risk in different groups of patients. A total of 18,529 patients (9,272 receiving perindopril/indapamide and 9,257 receiving placebo) were included in this meta-analysis involving three large randomized clinical trials-ADVANCE, PROGRESS and HYVET. A non-significant reduction in fatal and non-fatal stroke was seen (Odds ratio 0.73; 95% Confidence Interval 0.49 to 1.09; z=1.52 and p= 0.13). The combination was associated with a significantly reduction of vascular death (Odds ratio 0.79; 95% Confidence Interval 0.69 to 0.90; z=3.48 and p=0.0005) and major cardio-vascular events (Odds ratio 0.72; 95% Confidence Interval 0.53 to 0.97; z=2.15 and p= 0.03). Fixed-combination of Perindopril and indapamide substantially reduced major cardiovascular event and vascular death. However, effect on stroke needs further evaluation.
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Sougat Sourendra Sarkar (2011) studied this question.
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