A long-acting ACE inhibitor used to reduce blood pressure significantly decreased the risk for cardiovascular disease, including stroke, in normal weight, overweight and obese patients, according to research reported in Hypertension: Journal of the American Heart Association.

In the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), the rate of cardiovascular disease declined by more than 25 percent in normal weight, overweight and obese patient groups. The greatest benefit occurred in the heaviest patients, who started the study with higher blood pressure than their leaner counterparts, researchers said.

The treatment prevented one major cardiovascular event (defined as stroke, myocardial infarction or cardiovascular death) for every 13 obese patients treated, compared with one such event prevented for every 28 patients in the group that weighed the least.

"The absolute risk reduction was almost twice as great in the obese group," the investigators wrote in the journal. "These findings have important implications in the management of hypertension in the obese."

Although obesity is a recognized risk factor for stroke and other cardiovascular diseases, little is known about the effects of blood pressure-reducing medication on stroke incidence among obese patients.

To clarify these effects, investigators randomly assigned normal weight, overweight and obese patients either to receive the blood pressure-lowering drug perindopril or a placebo.

The five-year, international study included 6,105 people from 10 countries who had suffered a stroke within the previous five years.

The lead author of the study is Sebastien Czernichow, M.D., Ph.D., associate professor of nutrition at Avicenne Hospital, University of Paris 13.

Co-authors are Toshiharu Ninomiya, M.D., Ph.D.; Rachel Huxley, D.Phil.; Andre-Pascal Kengne, M.D.; G. David Batty, Ph.D., M.Sc.; Diederick E. Grobbee, M.D., Ph.D.; Mark Woodward, Ph.D.; Bruce Neal, M.D., Ph.D.; and John Chalmers, M.D.

Funding sources: Servier, the Health Research Council of New Zealand, and the National Health and Medical Research Council of Australia.