Antihypertensives to reduce blood pressure variability after stroke
Research type
Research Study
Full title
A Calcium channel or Angiotensin converting enzyme inhibitor/Angiotensin receptor blocker Regimen to reduce Blood pressure variability in acute ischaemic Stroke (CAARBS): A Feasibility Trial
IRAS ID
216241
Contact name
Thompson Robinson
Contact email
Sponsor organisation
University of Leicester
Eudract number
2017-002560-41
Duration of Study in the UK
1 years, 2 months, 30 days
Research summary
Hypertension is an important modifiable risk factor in primary and secondary stroke prevention. Good therapeutic blood pressure (BP) control has been shown to reduce recurrence after stroke or transient ischaemic attack (TIA). However, recent work has suggested BP variability (BPV) over short periods (minutes) as well as variation over days and weeks may be as important a risk factor as mean BP levels for stroke recurrence. Furthermore, studies looking at the effect of different classes of antihypertensive medications on BPV have shown that not all drug classes affect BPV equally. This differential effect on BPV may explain the differences in stroke risk reduction between different drug classes where the reduction in mean BP is similar. Strategies to treat BPV as well as mean BP levels after a stroke or TIA may therefore be clinically useful, but data relating to this are limited. This study will recruit hypertensive patients after their first ischaemic stroke or TIA prior to starting antihypertensive treatment who will undergo BPV measurements as used in previous studies and proven acceptable to patients. They will then be randomised to receive treatment with either a calcium channel blocker, or a renin-angiotensin antagonist (either an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker); these drug classes are commonly used to treat hypertension following stroke/TIA and are licensed for this use. BP levels and BPV measures will be repeated at 3 weeks and 3 months, and compliance with the medication will be assessed. Safety data on adverse effects will also be collected. The main aims are to assess the feasibility of recruiting from this patient group, and concordance rates with treatment and follow-up measurements. This information will help design a larger randomised controlled trial to investigate the effect of treatment strategies for BPV on stroke outcome.
REC name
London - Central Research Ethics Committee
REC reference
17/LO/1427
Date of REC Opinion
5 Sep 2017
REC opinion
Favourable Opinion