CHHIPS (Controlling Hypertension and Hypotension Immediately Post-Stroke) Pilot Trial: rationale and design.
BACKGROUND
High and low blood pressure (BP) levels are common following acute stroke, with up to 60% of patients being hypertensive (SBP > 160 mmHg) and nearly 20% having relative hypotension (SBP < or = 140 mmHg), within the first few hours of ictus, both conditions being associated with an adverse prognosis. At present, the optimum management of blood pressure in the immediate post-stroke period is unclear.


OBJECTIVE
The primary aim of the Controlling Hypertension and Hypotension Immediately Post-Stroke (CHHIPS) Pilot Trial is to assess whether hypertension and relative hypotension, manipulated therapeutically in the first 24 h following acute stroke, affects short-term outcome measures.


METHODS
The CHHIPS Pilot Trial is a UK based multi-centre, randomized, double-blind, placebo-controlled, titrated dose trial.


METHODS
Acute stroke and medical units in teaching and district general hospitals, in the UK.


METHODS
The CHHIPS Pilot Study aims to recruit 2050 patients, with clinically suspected stroke, confirmed by brain imaging, who have no compelling indication or contraindication for BP manipulation.


RESULTS
The primary outcome measure will be the effects of acute pressor therapy (initiated < or = 12 h from stroke onset) or depressor therapy (started < or = 24 h post-ictus) on death and dependency at 14 days post-stroke. Secondary outcome measures will include the influence of therapy on early neurological deterioration, the effectiveness of treatment in manipulating BP levels, the influence of time to treatment and stroke type on response and a cost-effectiveness analysis.
Potter
J
J
Department of Cardiovascular Science, Leicester Warwick Medical Schools, University Hospitals of Leicester NHS Trust, The Glenfield Hospital, Leicester, UK. jp34@le.ac.uk
Robinson
T
T
Ford
G
G
James
M
M
Jenkins
D
D
Mistri
A
A
Bulpitt
C
C
Drummond
A
A
Jagger
C
C
Knight
J
J
Markus
H
H
Beevers
G
G
Dewey
M
M
Lees
K
K
Moore
A
A
Paul
S
S
D000208:Acute Disease; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D015337:Multicenter Studies as Topic / Q000379:methods*; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D020521:Stroke / Q000150:complications*