Wilson, E.C.F., Ford, G.A,, Robinson, T. Mistri, A., Jagger, C., & Potter, J.F. (2010). “Controlling hypertension immediately post stroke: a cost utility analysis of a pilot randomised controlled trial.” Cost effectiveness and resource allocation, (8)3. Retrieved from: http://www.resource-allocation.com/content/8/1/3.
Elevated blood pressure (BP) levels are common following onset of acute stroke, and observational data suggest that both high and low BP levels are associated with poor short and long term prognosis. The acute management of post-stroke BP changes is a matter of some debate, with considerable differences of opinion on when to initiate antihypertensive therapy. A Cochrane review of BP manipulation following stroke concluded that there was insufficient evidence to evaluate the effect of changes on patient outcomes.
In view of the uncertainty surrounding appropriate response to BP control in the acute post-stroke phase, the Control of Hypertension and Hypotension Immediately Post Stroke (CHHIPS) trial (National Research Register Trial Number N0484128008) aimed to establish the safety, efficacy and cost-effectiveness of reducing BP with labetalol or lisinopril in hypertensive patients with acute cerebral infarction or haemorrhage, and of raising BP with phenylephrine in hypotensive patients with ischaemic stroke.