Thirty relevant RCTs were identified (n=202,157).
Combined outcomes: There was a lower risk of any event in the angiotensin-converting enzyme (ACE) inhibitor group versus comparator or placebo (OR 0.91, 95% CI 0.88 to 0.94). The effect was greater for perindopril alone (OR 0.82, 95% CI 0.77 to 0.88; five RCTs) than for the other studies excluding perindopril (OR 0.95, 95% CI 0.91 to 0.98; 11 RCTs).
Myocardial infarction: (18 studies) The effect was greater for perindopril alone (OR 0.78, 95% CI 0.72 to 0.85; three RCTs) than for studies excluding perindopril (OR 0.86, 95% CI 0.80 to 0.91).
Stroke: There was a reduction in risk for pooled ACE inhibitors (OR, 0.96, p=0.05). There was a greater reduction in risk for perindopril alone (OR 0.79, 95% CI 0.72 to 0.86). Studies excluding perindopril (17 RCTs) showed no significant effect.
All-cause mortality: The effect was greater for perindopril alone, which had a significant reduction versus placebo or other drugs (OR 0.89, 95% CI 0.84 to 0.95; six RCTs) than for studies excluding perindopril (OR 0.95, 95% CI 0.92 to 0.98; 23 RCTs). This absolute risk difference correlated to a NNT of 210 for other ACE inhibitors versus 127 for perindopril (p<0.0001).
Further results were reported including a comparison between results for enalapril/lisinopril and perindopril.