CHHIP Trial: Not Relevant to Hypertension Management
The CHHIP (Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer) trial is a prostate cancer radiotherapy study and has no implications for cardiovascular or hypertension treatment. The question appears to confuse CHHIP with cardiovascular trials like SPRINT or ACCORD BP.
What CHHIP Actually Studied
The CHHIP trial was a phase 3 randomized controlled trial in prostate cancer that compared:
- Conventional radiotherapy: 74 Gy in 37 fractions over 7.4 weeks
- Hypofractionated schedules: 60 Gy in 20 fractions over 4 weeks OR 57 Gy in 19 fractions over 3.8 weeks 1
The trial demonstrated that 60 Gy in 20 fractions was non-inferior to conventional 74 Gy in 37 fractions for biochemical/clinical failure-free survival in localized prostate cancer (88.3% vs 90.6% at 5 years), with similar long-term bowel, urinary, and sexual side effects 1, 2.
Key CHHIP Findings (Prostate Cancer Context Only)
Efficacy: The 60 Gy hypofractionated schedule achieved non-inferiority (HR 0.84,90% CI 0.68-1.03, p=0.0018) while the 57 Gy schedule did not meet non-inferiority criteria 1
Safety: Patient-reported outcomes showed no significant differences in moderate/severe bowel bother at 5 years: 5.4% (74 Gy), 7.6% (60 Gy), and 5.3% (57 Gy) 2
Quality of life: Sexual bother was actually less likely to worsen with hypofractionated schedules compared to conventional treatment (OR 0.55 for 60 Gy, OR 0.52 for 57 Gy vs 74 Gy) 2
Clinical Implication (Prostate Cancer Only)
Moderate hypofractionation using 60 Gy in 20 fractions should be considered the standard of care for external-beam radiotherapy in intermediate-risk localized prostate cancer 1, 2. This approach offers equivalent cancer control with similar toxicity profiles while reducing treatment duration from 7.4 weeks to 4 weeks, improving patient convenience and healthcare resource utilization 1, 3.
Common Pitfall to Avoid
Do not confuse CHHIP (a prostate cancer radiotherapy trial) with cardiovascular/hypertension trials. If the question intended to ask about blood pressure management trials, the relevant studies would be SPRINT, ACCORD BP, ADVANCE, or HOT—all of which are discussed extensively in the provided cardiovascular guidelines 4, 5, 6.