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Controlling Hypertension After Severe Cerebrovascular Event

A Multi-center Randomised Controlled Trial to Explore the Ideal Individualized Anti-hypertension Strategies in Patients With Severe Stroke at Acute Stage

NCT02982655•Xijing Hospital

View on ClinicalTrials.gov

Summary

The purpose of this academic lead study is to explore ideal blood pressure targets and optimum individualized anti-hypertension strategies in acute severe stroke.

Detailed Description

Of high mortality and morbidity, severe stroke is associated with devastating damages in neurologic, respiratory, circulatory and many other systems. The outcomes of patients with severe stroke depend largely on medical strategies on acute stage, especially on blood pressure (BP) management. Unfortunately, so far no ideal BP range has been scientifically determined for patients with acute severe stroke. The CHASE study aims to provide reliable data on the effects of individualized anti-hypertension strategy in patients with acute severe stroke (target recruitment 250) compared to standard guideline-based management of BP (target recruitment 250). Patients presenting with acute (\<72h) severe stroke (GCS ≦ 12 or NIHSS ≧ 11) and elevated BP (systolic blood pressure ≧150 mmHg or diastolic blood pressure ≧ 100 mmHg) will be randomly assigned to individualized anti-hypertension treatment or guideline-based treatment for 7 days.

Eligibility

Age

18 - No limit years

Sex

ALL

Healthy Volunteers

Inclusion Criteria

•1. age ≥ 18 years;
•2. the randomly assigned BP-lowering regimen is able to be commenced within 72 h after the onset of stroke (ischemic or hemorrhagic), confirmed by a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain (if the precise timing of the onset of symptoms or signs of the qualifying event is unknown, then the time of onset will be taken as the last time the patient was known to be well);
•3. GCS on admission ≤ 12 or NIHSS on admission ≥ 11;
•4. there are at least two SBP measurements of ≥ 150 and ≤ 210 mmHg, recorded ≥5 min apart (patients with an initial SBP \< 150 mmHg may be randomized when the SBP fulfils entry criteria on rechecking up to 72 h after the onset of stroke);
•5. written informed consent is able to be obtained directly from the patient or an appropriate surrogate, based on local ethics committee recommendations.

Exclusion Criteria

•1. patients who have received thrombolytic therapy, embolectomy, or decompressive craniectomy for the current stroke;
•2. patients with subarachnoid hemorrhage;
•3. known definite contraindication to acute BP lowering (e.g. known severe carotid, vertebral, or cerebral arterial stenosis, Moyamoya disease or Takayasu's arteritis, high grade stenotic valvular heart disease);
•4. secondary to a structural abnormality in the brain (e.g. an arteriovenous malformation, intracranial aneurysm, tumor, or trauma);
•5. unstable vital signs and requiring the use of vasoactive agents;
•6. known existing dementia or prestroke disability (e.g. score 3-5 on the modified Rankin scale);
•7. concomitant medical illness that would interfere with the outcome assessments and/or follow-up (advanced cancer; severe pulmonary dysfunction \[forced expiratory volume in 1 s \< 50%\]; severe cardiac dysfunction \[ejection fraction ≤ 50%\]; severe hepatic failure \[Child-Pugh score ≥ 7\]; severe renal failure \[glomerular filtration rate ≤ 30 mL/min or serum creatinine ≥ 4 mg/dL\]);
•8. patients who are currently participating in other investigational trials;
•9. patients who are considered to have a high likelihood of not adhering to the study treatment or the follow-up regimen.

Locations (26)

Ankang Central Hospital

Ankang, Shaanxi, China

Baoji Central Hospital

Baoji, Shaanxi, China

Hanzhong Central Hospital

Hanzhong, Shaanxi, China

Shangluo Central Hospital

Shangluo, Shaanxi, China

Tongchuan Mining Hospital

Tongchuan, Shaanxi, China

Tongchuan People's Hospital

Tongchuan, Shaanxi, China

Weinan Central Hospital

Weinan, Shaanxi, China

Xi'an 141 Hospital

Xi'an, Shaanxi, China

Department of Neurology, Xijing Hospital, Fourth Military Medical University

Xi'an, Shaanxi, China

Tangdu Hospital

Xi'an, Shaanxi, China

Key Dates

Start Date

January 1, 2017

Primary Completion Date

November 30, 2018

Completion Date

November 30, 2018

Last Updated

April 2, 2019

Enrollment

500

ESTIMATED participants

Conditions

Severe StrokeAcute StrokeHypertension

Interventions

Individualized BP lowering

PROCEDURE

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Data Source & Attribution

This clinical trial information is sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

ClinicalTrials.gov last update: April 2, 2019Data synced to Clareo: March 29, 2026

Modifications: This data has been reformatted for display purposes. Eligibility criteria have been parsed into inclusion/exclusion sections. Location data has been geocoded to enable distance-based search. For the authoritative and most current information, please visit ClinicalTrials.gov.

Neither the United States Government nor Clareo Health make any warranties regarding the data. Check ClinicalTrials.gov frequently for updates.

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Controlling Hypertension After Severe Cerebrovascular Event

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