Blood Pressure Lowering for the Prevention of Cognitive Decline in Patients with Cerebrovascular Disease

Cerebrovascular disease and high blood pressure both appear to increase the risk of vascular dementia. PROGRESS aims to investigate whether blood pressure lowering with an angiotensin converting enzyme inhibitor-based regimen will reduce the risk of cognitive impairment in patients with a history of stroke or transient ischaemic attack. A total of at least 6000 patients will be randomised to receive perindopril (± indapamide) or matching placebo(s), with treatment and follow-up scheduled to continue for at least 4 years. Substudies will investigate the effects of treatment on cognitive decline in subgroups defined by apo-E genotype and on white matter lesions assessed by magnetic resonance imaging. Final results from the study should be available in 2001.

[1]  N. Lassen Epidemiologic assessment of the role of blood pressure in stroke. , 1996, JAMA.

[2]  P J Whitehouse,et al.  Evaluation of dementia. , 1996, The New England journal of medicine.

[3]  L. Fried,et al.  Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. , 1996, Stroke.

[4]  C. Martyn Blood pressure and dementia , 1996, The Lancet.

[5]  B. Lernfelt,et al.  15-year longitudinal study of blood pressure and dementia , 1996, The Lancet.

[6]  M. Prince,et al.  Is the cognitive function of older patients affected by antihypertensive treatment? Results from 54 months of the Medical Research Council's treatment trial of hypertension in older adults , 1996, BMJ.

[7]  B. Winblad,et al.  Low blood pressure and dementia in elderly people: the Kungsholmen project , 1996, BMJ.

[8]  A. Mackinnon,et al.  Apolipoprotein E allele ∈4, dementia, and cognitive decline in a population sample , 1995, The Lancet.

[9]  C. Brayne,et al.  Epidemiology of vascular dementia. , 1995, Neuroepidemiology.

[10]  B. Johansson Pathogenesis of vascular dementia: the possible role of hypertension. , 1994, Dementia.

[11]  M. Albert,et al.  Are multiple cerebral infarcts synergistic? , 1994, Archives of neurology.

[12]  R. D'Agostino,et al.  Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. , 1993, American journal of epidemiology.

[13]  V. Hachinski Preventable senility: a call for action against the vascular dementias , 1992, The Lancet.

[14]  T. Tombaugh,et al.  The Mini‐Mental State Examination: A Comprehensive Review , 1992, Journal of the American Geriatrics Society.

[15]  L. Whalley,et al.  Senile hypertension and cognitive impairment: an overview. , 1992, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[16]  R. Doody,et al.  Establishing the limits of the Mini-Mental State. Examination of 'subtests'. , 1992, Archives of neurology.

[17]  L. Hebert,et al.  Relation of blood pressure to cognitive function in the elderly. , 1991, American journal of epidemiology.

[18]  J. V. van Swieten,et al.  Hypertension in the elderly is associated with white matter lesions and cognitive decline , 1991, Annals of neurology.

[19]  F Fazekas,et al.  Magnetic resonance imaging white matter lesions and cognitive impairment in hypertensive individuals. , 1991, Archives of neurology.

[20]  F. Boller,et al.  Hypertension and the risk of dementia in the elderly. , 1991, The American journal of medicine.

[21]  T. J. White,et al.  Treatment of hypertension in the elderly: II. Cognitive and behavioral function. Results of a Department of Veterans Affairs Cooperative Study. , 1990, Hypertension.

[22]  D P Salmon,et al.  The Mini-Mental State Examination in the early diagnosis of Alzheimer's disease. , 1990, Archives of neurology.

[23]  K. Blennow,et al.  White matter low attenuation on computed tomography in Alzheimer's disease and vascular dementia – diagnostic and pathogenetic aspects , 1989, Acta neurologica Scandinavica.

[24]  E. Kaplan,et al.  Blood pressure and cognitive performance. The Framingham Study. , 1987, American journal of epidemiology.

[25]  N. R. Schultz,et al.  Clinical significance of cognitive performance by hypertensive patients. , 1987, Hypertension.

[26]  R. L. Rogers,et al.  Improved cognition after control of risk factors for multi-infarct dementia. , 1986, JAMA.

[27]  A. Mazzucchi,et al.  Neuropsychological deficits in arterial hypertension , 1986, Acta neurologica Scandinavica.

[28]  H. E. King,et al.  Effect of antihypertensive treatment on the behavioral consequences of elevated blood pressure. , 1984, Hypertension.

[29]  D. Benson,et al.  Angular gyrus syndrome simulating Alzheimer's disease. , 1982, Archives of neurology.

[30]  M. Franceschi,et al.  Cognitive Processes in Hypertension , 1982, Hypertension.

[31]  J. L. Mack,et al.  Neuropsychological correlates of hypertension. , 1977, Archives of neurology.

[32]  P. Wolf,et al.  Components of Blood Pressure and Risk of Atherothrombotic Brain Infarction: The Framingham Study , 1976, Stroke.

[33]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[34]  C Eisdorfer,et al.  Intelligence and Blood Pressure in the Aged , 1971, Science.

[35]  P. Wolf,et al.  Epidemiologic assessment of the role of blood pressure in stroke. The Framingham study. , 1970, JAMA.