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In the PRoFESS study (JW Sep 4 2008), 20,322 patients with recent ischemic stroke were randomized to receive aspirin/dipyridamole or clopidogrel. However, the PRoFESS researchers did more than compare antiplatelet regimens; taking advantage of the trial’s 2×2 factorial design, they also randomized patients to receive the angiotensin-receptor blocker telmisartan or placebo.
Other antihypertensive drugs were used to control blood pressure, at the discretion of treating physicians. The premise of this arm of the study was that blockade of the renin-angiotensin system could have independent beneficial effects beyond lowering blood pressure in patients at high risk for vascular events. The study was supported by the maker of telmisartan.
During a …