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Controlling Hypertension After Severe Cerebrovascular Event (CHASE): A randomized, multicenter, controlled study
Fang Yuan1, Fang Yang1, Jingjing Zhao1
1Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Summary
Individualized blood pressure lowering did not significantly improve outcomes for severe stroke patients. This approach did not reduce the rate of death or dependence at three months compared to standard care.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Clinical Trials
Background:
- Optimal blood pressure targets in acute severe stroke remain uncertain.
- This study addresses the efficacy and safety of individualized versus standard blood pressure lowering strategies.
Purpose of the Study:
- To compare individualized blood pressure lowering with standard care in patients with acute severe stroke.
- To evaluate the impact on functional outcomes at 90 days.
Main Methods:
- 500 patients with acute severe stroke and elevated blood pressure were randomized.
- Interventions included individualized blood pressure lowering (10-15% SBP reduction) or standard care (<200 mmHg SBP for ischemic stroke, <180 mmHg for hemorrhagic stroke).
- Primary outcome was poor functional outcome at 90 days.
Main Results:
- Among 483 participants, 71.1% in the individualized group and 73.4% in the standard group had poor functional outcomes (OR, 0.75; 95% CI, 0.47-1.19; p=0.222).
- Serious adverse event rates were similar between groups (27.7% vs. 28.2%).
Conclusions:
- Individualized blood pressure lowering did not significantly reduce death or dependence at three months in acute severe stroke.
- Current evidence does not support a significant benefit of individualized blood pressure management over standard care in this patient population.
Keywords:
Blood pressureacute stroke therapycritical careindividualized therapyrandomized controlled trialsevere strokeMore Related Videos
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