Completed Heart, Stroke & Blood Brain & Nervous System

Improving the management of blood pressure in acute stroke: the Efficacy of Nitric Oxide in Stroke (ENOS) trial

Funder MRC (part of UKRI)
Recipient organisation University of Nottingham
Funding £4.1M
Period Nov 2006 — Sept 2009

In plain English

AI plain-English summary

Every year, around 5,000 stroke patients across 13 countries will be given a skin patch containing glyceryl trinitrate (GTN) within 48 hours of their stroke, to see if lowering their blood pressure improves their chances of recovery. This matters because high blood pressure is common immediately after a stroke, and patients with it are more likely to die or be left disabled. Yet doctors currently have no clear evidence on whether to treat it or leave it alone. The ENOS trial directly tests this clinical dilemma: does lowering blood pressure with GTN for seven days help, and should patients continue or stop their existing blood pressure medication during that time? If the trial shows GTN improves outcomes, it could change standard stroke care worldwide. A cheap, widely available skin patch would give doctors a simple, immediate tool to treat a dangerous condition that currently goes unmanaged. That could reduce the number of patients who die or become too disabled to care for themselves after a stroke—a direct, measurable improvement in everyday life for thousands of people each year.

View original technical description
The Efficacy of Nitric Oxide in Stroke (ENOS) Trial examines treating high blood pressure within 48 hours of stroke. Many patients have high blood pressure immediately after a stroke and we know that these people are more likely to die or be disabled than patients with normal blood pressure. At present, doctors do not usually treat high blood pressure immediately after a stroke so this trial investigates whether or not lowering blood pressure helps people to recover. We are using a well-established medication called glyceryl trinitrate (GTN) which relaxes blood vessels to lower blood pressure. The trial will recruit 5,000 patients and compares patients treated with GTN for 7 days against patients who do not receive GTN. The trial also examines whether or not patients blood pressure treatment should stop or continue for 7 days. Patients are followed up by telephone call at 90 days. The main outcome is comparison of the number of patients who have died or are too disabled to care for themselves after their stroke. ENOS is an international trial with 52 current centres recruiting patients across 13 countries. The trial is funded by the MRC until November 2011. The University of Nottingham is the sponsor.

View the original record at the funder ↗

Researchers

David Whynes (Co-Investigator)Joanna Wardlaw (Co-Investigator)Kennedy Lees (Co-Investigator)Philip Bath (Principal Investigator)Stuart Pocock (Co-Investigator)

Related Research

Grants with similar aims, by meaning.

ENOS-2 Efficacy of Nitric Oxide in Stroke-2
Investigation of effects of dietary nitrate on vascular function, platelet reactivity and restenosis in stable angina
An investigator-initiated and conducted, international, multicentre, stepped-wedge cluster, randomised controlled trial comparing the effects of different intensities of nursing care monitoring for patients with acute ischaemic stroke without critical care needs after thrombolysis treatment. (OPTIMISTmain)
TEST-BP: Trial of the Effectiveness and cost effectiveness of Self-monitoring and Treatment of Blood Pressure in secondary prevention following Stroke or Transient Ischaemic Attack (TIA)
An investigator-initiated and conducted, international, multicentre, stepped-wedge cluster, randomised controlled trial comparing the effects of different intensities of nursing care monitoring for patients with acute ischaemic stroke without critical care needs after thrombolysis treatment

Original classification

Research Grant

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