Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke: Rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122)

D. Thomas, P. M. Bath, K. Lees, F. J. Hextall, A. Skene, S. Pocock, J. M. Wardlaw, D. Whynes, P. M. Bath, C. Bladin, C. L. Chen, V. Caso, P. Desfontaines, A. Czlonkowska, J. Gommans, K. R. Lees, J. C. Navarro, S. J. Phillips, Y. J. Wang, L. WongP. A G Sandercock, K. Asplund, D. Bereczki, D. Bereczki, J. W. Wardlaw, R. Dineen, C. Weaver, U. Ferentzi, H. Stear, F. Hammonds, P. Rashid, M. Willmot, N. Sprigg, B. Whysall, L. Kaur, J. Leonardi-Bee, L. Gray, W. Clarke, Phillip Bath

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

High blood pressure (BP) is common in acute stroke and is independently associated with a poor outcome. Many patients with acute stroke are taking antihypertensive medications. To test the safety and efficacy of 7 days of transdermal glyceryl trinitrate (GTN, 5mg/day) vs. no GTN in patients with acute stroke; patients taking antihypertensive therapy immediately before their stroke are also randomised to continue vs. stop this temporarily. ENOS is a prospective international multicentre single-blind randomised-controlled trial in 5000 patients with acute (2) at 90 days measured by blinded central telephone follow-up. Secondary outcomes include: BP over the 7 days of treatment; death, impairment (Scandinavian stroke scale), recurrence, and neuroimaging at 7 days; discharge disposition, disability (Barthel index), cognition (mini-mental status examination) and quality of life (EuroQoL). The sample size will allow an absolute difference in death/dependency of 5% to be detected with 90% power at 5% significance for GTN versus no GTN. Randomisation and data collection are performed over a secure Internet site with real-time data validation. Neuroimaging and serious adverse events are adjudicated blinded to treatment.

Original languageEnglish
Pages (from-to)245-249
Number of pages5
JournalInternational Journal of Stroke
Volume1
Issue number4
DOIs
Publication statusPublished - Nov 2006

Fingerprint

Nitroglycerin
Antihypertensive Agents
Nitric Oxide
Stroke
Neuroimaging
Therapeutics
Random Allocation
Telephone
Internet
Sample Size
Cognition
Randomized Controlled Trials
Quality of Life
Blood Pressure
Hypertension
Safety
Recurrence

Keywords

  • Acute Stroke
  • AntihypertensiveTherapy
  • Cerebrovascular Disorders
  • Glyceryl Trinitrate
  • Randomised-Controlled Trial

ASJC Scopus subject areas

  • Neurology

Cite this

Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke : Rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122). / Thomas, D.; Bath, P. M.; Lees, K.; Hextall, F. J.; Skene, A.; Pocock, S.; Wardlaw, J. M.; Whynes, D.; Bath, P. M.; Bladin, C.; Chen, C. L.; Caso, V.; Desfontaines, P.; Czlonkowska, A.; Gommans, J.; Lees, K. R.; Navarro, J. C.; Phillips, S. J.; Wang, Y. J.; Wong, L.; Sandercock, P. A G; Asplund, K.; Bereczki, D.; Bereczki, D.; Wardlaw, J. W.; Dineen, R.; Weaver, C.; Ferentzi, U.; Stear, H.; Hammonds, F.; Rashid, P.; Willmot, M.; Sprigg, N.; Whysall, B.; Kaur, L.; Leonardi-Bee, J.; Gray, L.; Clarke, W.; Bath, Phillip.

In: International Journal of Stroke, Vol. 1, No. 4, 11.2006, p. 245-249.

Research output: Contribution to journalArticle

Thomas, D, Bath, PM, Lees, K, Hextall, FJ, Skene, A, Pocock, S, Wardlaw, JM, Whynes, D, Bath, PM, Bladin, C, Chen, CL, Caso, V, Desfontaines, P, Czlonkowska, A, Gommans, J, Lees, KR, Navarro, JC, Phillips, SJ, Wang, YJ, Wong, L, Sandercock, PAG, Asplund, K, Bereczki, D, Bereczki, D, Wardlaw, JW, Dineen, R, Weaver, C, Ferentzi, U, Stear, H, Hammonds, F, Rashid, P, Willmot, M, Sprigg, N, Whysall, B, Kaur, L, Leonardi-Bee, J, Gray, L, Clarke, W & Bath, P 2006, 'Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke: Rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122)', International Journal of Stroke, vol. 1, no. 4, pp. 245-249. https://doi.org/10.1111/j.1747-4949.2006.00059.x
Thomas, D. ; Bath, P. M. ; Lees, K. ; Hextall, F. J. ; Skene, A. ; Pocock, S. ; Wardlaw, J. M. ; Whynes, D. ; Bath, P. M. ; Bladin, C. ; Chen, C. L. ; Caso, V. ; Desfontaines, P. ; Czlonkowska, A. ; Gommans, J. ; Lees, K. R. ; Navarro, J. C. ; Phillips, S. J. ; Wang, Y. J. ; Wong, L. ; Sandercock, P. A G ; Asplund, K. ; Bereczki, D. ; Bereczki, D. ; Wardlaw, J. W. ; Dineen, R. ; Weaver, C. ; Ferentzi, U. ; Stear, H. ; Hammonds, F. ; Rashid, P. ; Willmot, M. ; Sprigg, N. ; Whysall, B. ; Kaur, L. ; Leonardi-Bee, J. ; Gray, L. ; Clarke, W. ; Bath, Phillip. / Glyceryl trinitrate vs. control, and continuing vs. stopping temporarily prior antihypertensive therapy, in acute stroke : Rationale and design of the Efficacy of Nitric Oxide in Stroke (ENOS) trial (ISRCTN99414122). In: International Journal of Stroke. 2006 ; Vol. 1, No. 4. pp. 245-249.
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