trials have used dementia as an outcome.6,19 – 21 We will focus here on studies with dementia outcomes and with follow-up of .1 year. Of the double-blind placebo-controlled trials carried out in older adults, the results of Syst-Eur stand out. They reported a significant 50% reduction in incident dementia over a mean follow-up of 2 years in those aged 60 or over (from 7.7/1000 patient years in the placebo group to 3.8 in the actively treated group).19 Systolic Hypertension in the Elderly Program (mean age 72) found a non- significant effect of treatment, with 36 (1.5%) incident cases in the active group and 44 (1.9%) in the placebo group.6 The Perindopril Protection against Recurrent Stroke Study (PROGRESS) trial, a sec- ondary prevention population post stroke or transient ischaemic attack (mean age 64 years) found fewer cases in the actively treated groups but no significant differences overall. When incident dementia was combined with recurrent stroke, the outcome became significant in favour of the actively treated group.