Toggle Main Menu Toggle Search

Open Access padlockePrints

COSSACS (Continue or Stop post-Stroke Antihypertensives Collaborative Study): rationale and design

Lookup NU author(s): Professor Gary Ford


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


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.

Publication metadata

Author(s): The COSSACS Trial Group

Publication type: Article

Publication status: Published

Journal: Journal of Hypertension

Year: 2005

Volume: 23

Issue: 2

Pages: 455-458

ISSN (print): 0263-6352

ISSN (electronic): 1473-5598

Publisher: Lippincott Williams & Wilkins


DOI: 10.1097/00004872-200502000-00029

Notes: 0263-6352 Journal article


Altmetrics provided by Altmetric