The angiotensin-converting enzyme inhibitor perindropril significantly limits progression of ischemic white-matter lesions in patients with prior stroke or transient ischemic attack, according to a presentation at the annual meeting of the American Academy of Neurology.

For the study, researchers randomized 226 patients with a history of ischemic stroke or transient ischemic attack to perindopril 4mg daily or placebo. All participants had a cerebral magnetic resonance imaging scan at baseline and at follow-up three years afterward to measure the presence and volume of incidental white matter lesions.

The prevalence of white matter lesions increases with age, is strongly associated with hypertension, and has been shown to increase the risk of dementia, severe cognitive impairment, or gait disturbances.

“Overall, the volume of new white matter lesions in the patients who took the placebo was 5 times higher compared to those who received the blood pressure medication?and more than 7.5 times higher for those patients who had severe white matter lesions upon entry,” said Carole Dufouil, PhD, presenter and part of the French research team. “Of those patients in the active treatment group who had severe white matter lesions upon entry, none experienced an increase in lesions. The results clearly indicate that a blood pressure lowering regimen in stroke patients stops or delays further ischemic brain damage.”