Randomised controlled trial of a Calcium Channel or Angiotensin Converting Enzyme Inhibitor?Angiotensin Receptor Blocker Regime to Reduce Blood Pressure Variability following Ischaemic Stroke (CAARBS): a protocol for a feasibility study.pdf (667.4 kB)
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Randomised controlled trial of a Calcium Channel or Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker Regime to Reduce Blood Pressure Variability following Ischaemic Stroke (CAARBS): a protocol for a feasibility study.

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journal contribution
posted on 01.05.2019, 10:12 by Thompson G. Robinson, William J. Davison, Peter M. Rothwell, John F. Potter
INTRODUCTION: Raised blood pressure (BP) is common after stroke and is associated with a poor prognosis, yet trials of BP lowering in the immediate poststroke period have not demonstrated a benefit. One possible explanation for this may be that BP variability (BPV) rather than absolute levels predicts outcome, as BPV is increased after stroke and is associated with poor outcomes. Furthermore, there is evidence of distinct antihypertensive class effects on BPV despite similar BP-lowering effects. However, whether BPV in the immediate poststroke period is a therapeutic target has not been prospectively investigated.The objectives of this trial are to assess the feasibility and safety of recruiting patients following an acute ischaemic stroke or transient ischaemic attack (TIA) to an interventional randomised controlled trial comparing the effects of two different antihypertensive drug classes on BPV. Secondary exploratory objectives are to assess if different therapeutic strategies have diverse effects on levels of BPV and if this has an impact on outcomes. METHODS: 150 adult patients with first-ever ischaemic stroke or TIA who require antihypertensive therapy for secondary prevention will be recruited within 7 days of the event from stroke services across three sites. After baseline assessments they will be randomly assigned to treatment with a calcium channel blocker or ACE inhibitor/angiotensin receptor blocker-based regimen and followed up for a period of three months. ETHICS AND DISSEMINATION: Ethical and regulatory approvals have been granted. Dissemination is planned via publication in peer-reviewed medical journals and presentation at relevant conferences. TRIAL REGISTRATION NUMBER: ISRCTN10853487.

Funding

This work was supported by a programme grant awarded jointly by The Stroke Association and The British Heart Foundation (Ref: TSA BHF 2012/01). The study is sponsored by the University of Leicester.

History

Citation

BMJ Open, 2019, 9 (2), e025301

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

BMJ Open

Publisher

BMJ Publishing Group

eissn

2044-6055

Acceptance date

07/11/2018

Copyright date

2019

Available date

01/05/2019

Publisher version

https://bmjopen.bmj.com/content/9/2/e025301

Language

en

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