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A patient who suffers a nonfatal stroke or transient ischemic attack (TIA) is at high risk for stroke within 5 years of the initial event. In this partially industry-funded study, researchers randomized, in double-blind fashion, 6105 patients with histories of stroke or TIA (48 percent with hypertension) to either a blood-pressure lowering regimen (4 mg daily of the ACE inhibitor perindopril) or matching placebo. At the treating physicians' discretion, more than half of perindopril recipients also received the diuretic indapamide (double placebo was used to match this combination). Mean follow-up was 4 years.
Compared with placebo, active treatment lowered BP by a mean 9/4 mm Hg; BP reduction among combination-therapy recipients was roughly …