Abstract: ObjectiveTo investigate the protective effect of blood pressure-lowering regimen with perinopril combined indapamide against recurrence of stroke.MethodsFifty patients with a history of stroke （ischemic or hemorrhagic） in the past 5 years were randomly, double-blindly assigned to active treatment group （perindopril, 4 mg/d） combined with diuretic indapamide（2.5 mg/d） or control group （with matching placebo）, each 25 cases.The duration of care and follow-up was 5 years with double-blind continuous follow-up, and for another 2.5 years after opening the blind.The study end-point was stroke events, cardiovascular death and total cardiovascular events, dementia, and disability.At each follow-up time, blood pressure, heart rate, serum potassium and creatinine, as well as MMSE score and Barthel Index score were measured periodically.Results Over 5 years of follow-up, active treatment obviously reduced blood pressure from （155 ±26/92 ±11）mm Hg to （125±25/82±13）mm Hg （P＜0.01）. While in the control treatment a slightly reduced blood pressure from （157±26/92±12）mm Hg to （150±25/90±11）mm Hg with no significant difference （P＞0.05）.As compared to the control group, the active treatment group had 4 cases of stroke events （16%） vs 11 cases （44%） in control group（P＜0.01）, cardiovascular death 2 cases（8%） vs 8 cases （32%） P＜0.05, the total vascular events 5 cases （20%） vs 19 cases （76%） （P＜0.01） respectively.In addition, the active treatment produced less rate of dementia and disability than the placebo （P＞0.05）. Conclusion The blood pressure-lowering regimen based on perinopril combined with indapamide not only reduce the risk of recurrent stroke, but also reduce the risk of cardiovascular death and total vascular events, and the rates of dementia and disability.Therefore, expanding the blood pressure-lowering regimen as an efficient secondary prevention for stroke is warranted.