Why is this research needed?
People who have survived a stroke or transient ischaemic attack (TIA) are at a particularly high risk of stroke. 30% of people with stroke or TIA have another stroke in the following five years.
High blood pressure is the most important risk factor for having a stroke that can be managed. Previous studies suggest that measuring blood pressure at home (self-monitoring) may help to control blood pressure.
What are the researchers hoping to do?
The aim of this study is to develop and test a self-monitoring programme for blood pressure that is suitable for people with stroke and TIA. The researchers hope it will help people to manage their blood pressure and reduce their risk of stroke. They will also look at whether the programme is cost effective for the NHS.
The programme will include self-adjustment of blood pressure medication where possible in consultation with a GP. GPs will also receive reminders to think about problems people with stroke and TIA may have with taking medication and potential specialist referral if their patient’s blood pressure remains high.
The study has three parts:
Part one will develop the self-monitoring programme by trying it out with patients and GPs who will be asked to talk about what they think of it.
Part two will test if the self-monitoring treatment works in a randomised controlled trial (RCT) by comparing patients who self-monitor with those that receive usual GP care.
Part three will assess if the new treatment is cost-effective.
What happened?
Unfortunately, our charity and the British Heart Foundation made the decision to close this study in September 2020.
Early in the Covid-19 pandemic, restrictions on contact with people and patients in healthcare and research were put in place for public health.
The Covid-19 pandemic means there has been significant changes in usual care, which also varies between the GP practices participating in the trial. Part two of the study would compare the effect of the blood pressure monitoring being tested in this study may not be so large, when compared to the control group. This would make it very difficult to find out the difference the new self-monitoring treatment can make.
The researchers started closing down the study in October 2020. This included:
Getting ethical approval to close the study.
Informing staff, and the stroke survivors, people with TIA and GP practices taking part.
Reporting on findings from the research between 2018-20. This includes increasing knowledge on how a self-monitoring treatment for blood pressure could be developed and tested.
It’s disappointing that due to the Covid-19 pandemic this research had to stop. The question of how stroke survivors and people with TIA can manage their blood pressure and reduce their risk of stroke is a very important research question. This project bought together a world class team to answer it.
The impact of the Covid-19 pandemic meant this study was no longer able to answer the question as it had hoped. However, our charity and partners hope to fund future research that can stop stroke and TIA survivors having further strokes.