COSSACS (Continue or Stop Post-Stroke Antihypertensives Collaborative Study): Rationale and design

Robinson, T. G., The COSSACS Trial Group and Paul, Sanjoy (2005) COSSACS (Continue or Stop Post-Stroke Antihypertensives Collaborative Study): Rationale and design. Journal of Hypertension, 23 2: 455-458. doi:10.1097/00004872-200502000-00029


Author Robinson, T. G.
The COSSACS Trial Group
Paul, Sanjoy
Title COSSACS (Continue or Stop Post-Stroke Antihypertensives Collaborative Study): Rationale and design
Journal name Journal of Hypertension   Check publisher's open access policy
ISSN 0263-6352
1473-5598
Publication date 2005-02
Sub-type Article (original research)
DOI 10.1097/00004872-200502000-00029
Volume 23
Issue 2
Start page 455
End page 458
Total pages 4
Place of publication London, United Kingdom
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Rationale: Up to 40% of acute stroke patients are already taking antihypertensive therapy on hospital admission, and most will develop elevated blood pressure levels as an acute complication of the stroke. However, no clear data exist as to whether antihypertensive therapy should be continued or discontinued in the acute situation. Surveys of clinical practice reveal significant physician variability and no clear guidelines exist.

Objectives: The primary aim of the Continue or Stop post-Stroke Antihypertensives Collaborative Study (COSSACS) is to assess whether existing antihypertensive therapy should be continued or discontinued within the first 24 h for the first 2 weeks following acute ischaemic and haemorrhagic stroke onset.

Design:
COSSACS is a multi-centre, prospective, randomized, open, blinded-endpoint study, in which patients on pre-existing antihypertensive therapy, admitted to hospital within 24 h of onset of suspected stroke, and within 36 h of their last dose of antihypertensive medication, are randomized to continue or stop current antihypertensive therapy.

Setting:
Acute Stroke Units/ Medical Units of at least 25 UK Teaching and District General Hospitals.

Patients:
The study will involve 2900 patients with suspected stroke without specific indication to continue or stop their antihypertensive medication in the opinion of their treating clinician.

Study outcomes: The primary outcome for COSSACS is the proportion of patients who are dead or dependent (defined by a modified Rankin score > 2) at 14 days post-stroke.

Secondary outcomes:
include blood pressure changes, and neurological and functional status at 2 weeks and 6 months post-ictus.
Keyword Stroke
Hypertension
Anti hypertensive medication
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Members of The COSSACS Trial Group listed at the end of the paper.

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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Created: Wed, 17 Nov 2010, 12:17:52 EST