AzTrials
AzTrials

Gestational HypertensionNCT01192412

The CHIPS Trial (Control of Hypertension In Pregnancy Study)

A study testing Intervention is blood pressure management approach and Intervention is blood pressure management approach. in people with Gestational Hypertension, run by University of British Columbia at 111 sites in 15 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The investigators do not know which approach to treatment of non-severe high blood pressure in pregnancy is better for women and babies. In the CHIPS Trial, the investigators seek to determine whether 'less tight' control (aiming for a diastolic blood pressure [dBP] of 100 mmHg), compared with 'tight' control (aiming… Read more about this study

Who is it for?
Any age, women only
Conditions the study is for
Gestational Hypertension
What is being tested?
Intervention is blood pressure management approach and Intervention is blood pressure management approach.
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
987 participants
Where
111 sitesin 15 countries
Study dates
Apr 2009to Feb 2014
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Pre-existing or gestational hypertension (pre-existing hypertension is dBP greater than or equal to 90 mmHg before pregnancy or 20 weeks' gestation; gestational hypertension is dBP greater than or equal to 90 mmHg that develops after 20 weeks)
  • dBP of 90 - 105 mmHg if NOT TAKING antihypertensive therapy, or dBP of 85 - 105 mmHg if TAKING antihypertensive therapy
  • Live foetus (confirmed by Doptone assessment of foetal heart tones within one week before randomisation)
  • Gestational age 14 - 33+6 weeks (as measured by last menstrual period or dating ultrasound)

Who cannot join

  • Severe systolic hypertension (defined as a systolic blood pressure [sBP] greater than or equal to 160 mmHg at randomisation)
  • Proteinuria (defined as greater than or equal to 0.3 g/d by 24 hour urine collection, or if a 24 hour urine collection is not available, by a urinary protein:creatinine ratio of greater than or equal to 30 mg/mmol or urinary dipstick of greater than or equal to 2+)
  • Use of an angiotensin converting enzyme (ACE) inhibitor at greater than or equal to 14+0 weeks' gestation
  • Contraindication to either arm of the trial or to pregnancy prolongation
  • Known multiple gestation
  • Known lethal or major foetal anomaly
  • Plan to terminate pregnancy
  • Prior participation in CHIPS

Trial locations and contacts

111 sites in 15 countries.

111 sites in 15 countries

United Kingdom28 sites
  • Basildon & Thurrock University Hospital

    Basildon

  • Birmingham Women's Hospital

    Birmingham

  • East Lancashire Hospitals NHS Trust

    Blackburn

  • Bradford Royal Infirmary

    Bradford

  • Chesterfield Royal Hospital

    Chesterfield

  • University Hospital Coventry and Warwickshire

    Coventry

  • The Royal Derby Hospital

    Derby

  • Calderdale Royal Hospital

    Halifax

  • Lancashire Teaching Hospitals NHS Foundation Trust

    Lancashire

  • Royal Lancaster Infirmary

    Lancaster

  • Leicester Royal Infirmary

    Leicester

  • Liverpool Women's Hospital

    Liverpool

  • Guy's & St Thomas' Hospital

    London

  • Queen Elizabeth Hospital

    London

  • St Mary's Hospital

    Manchester

  • Royal Victoria Infirmary

    Newcastle upon Tyne

  • Nottingham City Hospital

    Nottingham

  • Queen's Medical Centre

    Nottingham

  • King's Mill Hospital

    Nottinghamshire

  • Southport & Ormskirk Hospital

    Ormskirk

  • Derriford Hospital

    Plymouth

  • Sheffield Teaching Hospitals NHS Foundation Trust

    Sheffield

  • Wexham Park Hospital

    Slough

  • City Hospitals Sunderland NHS Foundation Trust

    Sunderland

  • Singleton Hospital

    Swansea

  • South Warwickshire NHS Trust

    Warwickshire

  • New Cross Hospital

    Wolverhampton

  • York District Hospital

    York

Other trials in United Kingdom

Canada21 sites
  • Calgary Health Region - Foothills Hospital

    Calgary, Alberta

  • Royal Alexandra Hospital

    Edmonton, Alberta

  • IWK Health Centre

    Halifax, Nova Scotia

  • London Health Sciences Centre

    London, Ontario

  • Hopital Sainte-Justine

    Montreal, Quebec

  • Royal Victoria Hospital

    Montreal, Quebec

  • Ottawa Hospital Civic Division

    Ottawa, Ontario

  • Ottawa Hospital General Division

    Ottawa, Ontario

  • Regina General Hospital

    Regina

  • Royal University Hospital

    Saskatoon, Saskatchewan

  • CHUS Fleurimont

    Sherbrooke, Quebec

  • Women's Health Centre

    St. John's, Newfoundland and Labrador

  • Jim Pattison Outpatient Care and Surgery Centre

    Surrey, British Columbia

  • Mount Sinai Hospital

    Toronto, Ontario

  • St Michael's Hospital

    Toronto, Ontario

  • Sunnybrook Health Sciences Centre

    Toronto, Ontario

  • Toronto East General Hospital

    Toronto, Ontario

  • University of British Columbia, Department of Obstetrics & Gynaecology

    Vancouver, British Columbia, V6H 3N1

  • Children's & Women's Health Centre of BC

    Vancouver, British Columbia

  • St Paul's Hospital

    Vancouver, British Columbia

  • St Boniface General Hospital

    Winnipeg, Manitoba

Other trials in Canada

Netherlands18 sites
  • Jeroen Bosch Hospital

    's-Hertogenbosch

  • Flevo ziekenhuis

    Almere Stad

  • Meander Medisch Centrum

    Amersfoort

  • Academic Medical Center

    Amsterdam

  • OLVG

    Amsterdam

  • VU Medical Center

    Amsterdam

  • Medisch Spectrum Twente

    Enschede

  • UMCG

    Groningen

  • Kennemer Gasthuis Haarlem

    Haarlem

  • Tergooiziekenhuizen

    Hilversum

  • Spaarne Ziekenhuis

    Hoofddorp

  • MUMC Maastricht

    Maastricht

  • St Antonius Ziekenhuis

    Nieuwegein

  • Ziekenhuis Bernhoven

    Oss

  • Diakonessen Ziekenhuis

    Utrecht

  • UMCU

    Utrecht

  • Maxima Medical Centre

    Veldhoven

  • Isala Klinieken Zwolle

    Zwolle

Other trials in Netherlands

United States11 sites
  • Beth Israel Deaconess

    Boston, Massachusetts

  • Cooper University Hospital

    Camden, New Jersey

  • University of North Carolina

    Chapel Hill, North Carolina

  • Medical University of South Carolina

    Charleston, South Carolina

  • East Carolina University

    Greenville, North Carolina

  • Norton Hospital Downtown

    Louisville, Kentucky

  • Norton Suburban Hospital

    Louisville, Kentucky

  • Meriter Hospital

    Madison, Wisconsin

  • University of Minnesota

    Minneapolis, Minnesota

  • Yale-New Haven Hospital

    New Haven, Connecticut

  • Oregon Health and Science University

    Portland, Oregon

Other trials in United States

Brazil7 sites
  • Hospital Materno Infantil

    Goiânia

  • Hospital Universitario Antonio Pedro

    Niterói

  • Hospital Sao Lucas - PUCRS

    Porto Alegre

  • Maternidade Escola da UFRJ

    Rio de Janeiro

  • Clinica Perinatal Barra

    Rio de Janerio

  • Laranjeiras Clinica Perinatal

    Rio de Janerio

  • Maternidade Escola de Vila Nova Cachoeirinha

    São Paulo

Other trials in Brazil

Australia6 sites
  • Women's and Children's Hospital

    Adelaide

  • Campbelltown Hospital

    Campbelltown, New South Wales

  • Ipswich Hospital

    Ipswich

  • Liverpool Hospital

    Liverpool, New South Wales

  • King Edward Memorial Hospital

    Subiaco

  • St John of God Hospital

    Subiaco

Other trials in Australia

Argentina4 sites
  • Hospital JR Vidal

    Corrientes

  • Hospital LC Lagomaggiore

    Mendoza

  • Hospital Avellaneda

    San Miguel de Tucumán

  • Hospital JM Cullen

    Santa Fe

Other trials in Argentina

Colombia3 sites
  • Clinica Materno Infantil Farallones

    Cali

  • Clinica Versalles

    Cali

  • Corporacion Conmfenalco Valle - Universidad Libre

    Cali

Other trials in Colombia

Israel3 sites
  • Ma'ayney Hayeshua Medical Center

    Bnei Brak

  • Hillel Yaffe Medical Center

    Hadera

  • Nazareth Hospital (EMMS)

    Nazareth

Other trials in Israel

Poland3 sites
  • Medical University of Gdansk

    Gdansk

  • Polish Mothers Memorial Hospital

    Lodz

  • University School of Medical Sciences

    Poznan

Other trials in Poland

Chile2 sites
  • Hospital Base Osorno

    Osorno

  • Hospital Dr Sotero del Rio

    Puente Alto

Other trials in Chile

New Zealand2 sites
  • Waitemata Health-North Shore Hospital

    Auckland

  • Christchurch Women's Hospital

    Christchurch

Other trials in New Zealand

Estonia1 site
  • Tartu University Hospital-Women's Clinic

    Tartu

Other trials in Estonia

Hungary1 site
  • University of Debrecen

    Debrecen

Other trials in Hungary

Jordan1 site
  • Islamic Hospital

    Amman

Other trials in Jordan

About this study

The investigators do not know which approach to treatment of non-severe high blood pressure in pregnancy is better for women and babies.

In the CHIPS Trial, the investigators seek to determine whether 'less tight' control (aiming for a diastolic blood pressure [dBP] of 100 mmHg), compared with 'tight' control (aiming for a diastolic blood pressure [dBP] of 85 mmHg) can decrease the risks of adverse baby outcomes without increasing the risk of problems for the mother.

Read the detailed description

Primary research question:

For pregnant women with non-severe, non-proteinuric maternal hypertension at 14-33 weeks, will 'less tight' control (target diastolic blood pressure [dBP] of 100 mmHg) versus 'tight' control (target dBP of 85 mmHg) increase (or decrease) the likelihood of pregnancy loss or Neonatal Intensive Care Unit (NICU) admission for greater than 48 hours?

Secondary research question:

Will 'less tight' versus 'tight' control increase (or decrease) the likelihood of serious maternal complications?

Other research questions:

Will 'less tight' versus 'tight' control:

  1. Increase (or decrease) the likelihood of serious perinatal complications?
  2. Increase (or decrease) the likelihood of severe hypertension and pre-eclampsia?
  3. Increase (or decrease) the likelihood of maternal satisfaction with care?
  4. Result in significant changes in dBP or health care costs?

Treatment Allocation:

Eligible women will be randomised centrally to either 'less tight' control (aiming for dBP of 100mmHg) or 'tight' control (aiming for dBP of 85mmHg) of their hypertension.

Randomisation will be stratified by centre and type of hypertension (pre-existing or gestational).

  • In the 'less tight' control group, if dBP is ≥105mmHg, then antihypertensive medication must be started or increased in dose.
  • In the 'tight' control group, if dBP is ≤80mmHg, then antihypertensive medication must be decreased in dose or discontinued.
  • In both groups, centres will provide their usual care. Data will be collected on potential co-interventions (e.g., hospitalisation, bedrest).

Outcomes:

Primary: Pregnancy loss (miscarriage or ectopic pregnancy, pregnancy termination, stillbirth, or neonatal death) or high level neonatal care for >48 hours in the first 28 days of life or prior to primary hospital discharge, whichever is later.

Secondary: One/more serious maternal complication(s) until six weeks postpartum.

Follow-up:

Compliance (dBP and antihypertensive dose) will be assessed within 4 weeks of randomisation. Outcome data will be collected during the woman's (and baby's) hospital stay for birth (or loss). Women will be contacted 6 to 12 weeks after delivery (or loss) and, for preterm babies, when the baby is at 36 weeks corrected gestational age to enquire about satisfaction with care and any major maternal/neonatal morbidity following hospital discharge.

Being tested
Intervention is blood pressure management approach, Intervention is blood pressure management approach.
Keywords
hypertension, pregnancy, antihypertensive therapy, perinatal outcome, maternal outcome, Non-severe, non-proteinuric pre-existing or gestational hypertension in pregnancy
Medical subject headings
Hypertension, Pregnancy-Induced, Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intervention is blood pressure management approachProcedure or surgery

    1. 'Less tight' control. The dBP treatment goal is 100 mmHg. For safety, if dBP is >105 mmHg, then antihypertensive medication must be started or increased in dose. For dBP <100 mmHg, antihypertensive therapy should be decreased in dose or stopped, as appropriate. The intervention will be applied until delivery.
  • Intervention is blood pressure management approach.Procedure or surgery

    'Tight' control. The dBP treatment goal is 85 mmHg. For safety, if dBP is <80 mmHg, then antihypertensive medication must be decreased in dose or discontinued. If dBP is >85 mmHg, then antihypertensive therapy should be started or increased in dose. The intervention will be applied until delivery.

Study groups in NCT01192412
Study groupRoleWhat they receive
'Less tight' control.Active comparatorThe diastolic blood pressure (dBP) treatment goal is 100 mmHg.
Receives: Procedure: Intervention is blood pressure management approach
'Tight' control.Active comparatorThe diastolic blood pressure (dBP) treatment goal is 85 mmHg.
Receives: Procedure: Intervention is blood pressure management approach.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pregnancy Loss or NICU Admission for Greater Than 48 Hours

    Pregnancy loss or NICU admission for greater than 48 hours, as recorded in the maternal and infant medical records immediately following the birth (or pregnancy loss), and then again after the mothers' and infants' discharge home. Supplemental information, about potential post-discharge maternal or neonatal morbidities in the 6 weeks following birth for the mother, or 28 days of life for the baby, will be obtained by contacting women at 6 weeks postpartum and/or from medical records.

    Measured: 6 weeks

Secondary outcomes (1)
  1. Serious Maternal Complications Measured up to 6 Weeks Postpartum

    Serious maternal complications measured up to 6 weeks postpartum. Death or one or more life-threatening maternal complications:

    1. Adverse neurological complications (stroke, eclampsia, and/or blindness), and/or
    2. End-organ failure (uncontrolled hypertension, inotropic support, pulmonary oedema, respiratory failure, myocardial ischaemia/infarction, renal failure, coagulopathy, and/or transfusion)

    Measured: 6 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Sep 2010 (estimated)
  2. Study startApr 2009
  3. Primary completionFeb 2014
  4. Study completionFeb 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
987 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01192412
Sponsor's protocol ID
H08-00882
Other IDs
MCT-87522, 07-3431
Status last verified
Nov 2016
First submitted
30 Aug 2010
Last updated
11 Jan 2017
Data monitoring committee
Yes

Publications

  • Metcalfe RK, Harrison M, Singer J, Lewisch M, Lee T, von Dadelszen P, Magee LA, Bansback N; CHIPS Study Group. Using a patient-centred composite endpoint in a secondary analysis of the Control of Hypertension in Pregnancy Study (CHIPS) Trial. Trials. 2023 Feb 7;24(1):99. doi: 10.1186/s13063-023-07118-1.

    PubMed 36750953
  • Magee LA, Singer J, Lee T, McManus RJ, Lay-Flurrie S, Rey E, Chappell LC, Myers J, Logan AG, von Dadelszen P. Are blood pressure level and variability related to pregnancy outcome? Analysis of control of hypertension in pregnancy study data. Pregnancy Hypertens. 2020 Jan;19:87-93. doi: 10.1016/j.preghy.2019.12.002. Epub 2020 Jan 9.

    PubMed 31927325
  • Vidler M, Magee LA, von Dadelszen P, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Singer J, Gafni A, Gruslin A, Helewa M, Hutton E, Lee SK, Lee T, Logan AG, Ganzevoort W, Welch R, Thornton JG, Moutquin JM; CHIPS Study Group. Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study). Eur J Obstet Gynecol Reprod Biol. 2016 Nov;206:105-113. doi: 10.1016/j.ejogrb.2016.07.509. Epub 2016 Sep 10.

    PubMed 27665372
  • Magee LA, von Dadelszen P, Singer J, Lee T, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Gafni A, Helewa M, Hutton E, Koren G, Lee SK, Logan AG, Ganzevoort W, Welch R, Thornton JG, Moutquin JM; CHIPS Study Group*. The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure? Hypertension. 2016 Nov;68(5):1153-1159. doi: 10.1161/HYPERTENSIONAHA.116.07862. Epub 2016 Sep 12.

    PubMed 27620393
  • Ahmed RJ, Gafni A, Hutton EK, Hu ZJ, Pullenayegum E, von Dadelszen P, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez JJ, Ganzevoort W, Helewa M, Lee SK, Lee T, Logan AG, Moutquin JM, Singer J, Thornton JG, Welch R, Magee LA. The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial). Hypertension. 2016 Oct;68(4):1049-55. doi: 10.1161/HYPERTENSIONAHA.116.07466. Epub 2016 Aug 22.

    PubMed 27550914
  • Magee LA, von Dadelszen P, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Singer J, Gafni A, Gruslin A, Helewa M, Hutton E, Lee SK, Lee T, Logan AG, Ganzevoort W, Welch R, Thornton JG, Moutquin JM. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015 Jan 29;372(5):407-17. doi: 10.1056/NEJMoa1404595.

    PubMed 25629739

Questions about this trial

What is this clinical trial studying?

A study testing Intervention is blood pressure management approach and Intervention is blood pressure management approach. in people with Gestational Hypertension, run by University of British Columbia at 111 sites in 15 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 111 sites in United Kingdom, Canada, Netherlands, United States, Brazil and 10 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Jan 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pregnancy Loss or NICU Admission for Greater Than 48 Hours (time frame: 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01192412, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jan 2017.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in