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

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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.