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Prevention of hypertensive injury to the brain by intensive treatment in intracerebral haemorrhage

A pilot randomised trial of home telemetry-guided treatment 

closed to recruitment 31/01/2022 -  86 randomised (12 UCL, 3 IMPERIAL, 5 ST GEORGES , 7 OXFORD, 4 glasgow, 1 salford, 4 Sheffield, 8 kings, 10 Edinburgh, 5 nottingham, 15 Addenbrookes, 2 lUTON AND dUNSTABLE, 4 Bath, 4 West Suffolk, 2 croydon)

COVID-19

If you are a participant or have a participant with fever, cough or shortness of breath returning a 24hr monitor to the Oxford Monitoring team, please place equipment into two bags prior to sending using the prepaid envelope. This enables us to handle it in accordance with the Public Health England guidelines for COVID-19. All CPSD clinics follow Oxford University Hospitals NHS Foundation Trust infection control guidelines.

The trial will show whether intensive lowering of blood pressure (BP) using telemetric home monitoring in survivors of intracerebral haemorrhage (ICH) is feasible, safe and effective in reducing brain injury. If successful this study will be a precursor for a larger definitive trial. Our intervention should allow survivors of ICH to know, understand, and manage their own BP to prevent strokes and cognitive impairment, and improve outcomes.

PROHIBIT-ICH will randomise participants to compare a strategy of intensive BP treatment (target <120/80 mm Hg) guided by telemetric home monitoring, versus standard primary care (current RCP guideline is 130/80 mm Hg), in 112 adult survivors of hypertension-related ICH. We will establish the feasibility and safety of the intervention, the efficacy of BP reduction, and explore whether it reduces the progression of small vessel disease (SVD) related injury on brain MRI.



Oxford Team

UCL TEAM

Professor David Werring -Professor of Clinical Neurology Stroke Research Centre UCL Institute of Neurology. 
d.werring@ucl.ac.uk

Professor Rolf Jager - Neuroimaging Centre UCL Institute of Neurology.
r.jager@ucl.ac.uk

Professor Frederik Barkhof - Chair of Neuroradiology Brain Repair and Rehabilitation UCL Institute of Neurology.
f.barkhof@ucl.ac.uk

Dr. David Thomas - Neuroimaging Analysis Centre Department of Brain Repair and Rehabilitation, UCL Institute of Neurology.
d.thomas@ucl.ac.uk