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Staff in Stroke Medicine

Efficacy of Nitric Oxide in Stroke (ENOS) trial in New Zealand


Background - Elevated blood pressure is the strongest risk factor for stroke.  It is uncertain whether lowering blood pressure in the first week after a stroke will improve or worsen clinical outcomes. Nitric oxide is a vasodilator for both cerebral and systemic blood vessels. Nitric oxide also possesses anti-apoptotic properties and directly modulates neural function.

Methods - The Efficacy of Nitric Oxide in Stroke (ENOS) trial has enrolled over 3,800 patients worldwide in an effort to elucidate the best way to treat hypertension in the first week after a stroke. ENOS also hopes to determine whether nitric oxide treatment will provide a clinically significant improvement in patient function 90 days post stroke.

Results - Thus far, 90-day clinical outcomes for New Zealand patients are significantly better (p-value 0.0021) than the outcomes for ENOS patients in the rest of the world. In New Zealand 29 of 63 Patients (46%) are dead or dependent (modified Rankin Score of >2) at 90 days post stroke. In the rest of the world, 1,804 out of 2,909 ENOS patients (62%) are dead or dependent at 90 days post stroke.

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