The COBRA-BPS trial was co-conducted by International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Aga Khan University, Pakistan, the University of Kelanyia, Sri Lanka, and coordinated by Duke-National University of Singapore revealed the result of a study published in the New England Journal of Medicine on Thursday.
According to tri-nation study, community healthcare workers to monitor patients’ blood pressure (BP) along with lifestyle coaching to them could effectively control high blood pressure.
The study titled ‘Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka (COBRA-BPS)’ is a bunch randomised trial that closely examined 2,550 individuals with hypertension living in 30 rural communities in three countries between 2016 and 2019.
In Bangladesh, icddr,b implemented the trial among 895 hypertensive individuals in Munshiganj and Tangail districts in close collaborations with the NCD Control Programme of the Directorate General of Health Services and and Ministry of Health and Family Welfare.
In the COBRA intervention areas, six health assistants (HAs) measured blood pressure of 447 study patients at homes using a digital blood pressure machine and provided education for promotion of lifestyle.
The HAs referred patients with uncontrolled blood pressure to selected upazila hospital where doctors treated those patients following a treatment protocol and mobilised supplies of anti-hypertensive drugs for the patients.
Dr Aliya Naheed, study’s principal investigator in Bangladesh and the country lead, said, “It was quite satisfying to observe that the hypertensive individuals who received COBRA care had at least 5mm Hg (millimetres of mercury) reduction in their systolic blood pressure in a year that sustained up to two years.”
“COBRA intervention can be a potential solution for controlling blood pressure and preventing deaths from heart attack and stroke the leading causes of premature deaths in Bangladesh,” she added.
The principal investigator also said, "We look forward to obtaining all out support from the government for scaling up this low cost strategy for effective control of blood pressure in rural areas in Bangladesh.”
Data suggests that programme delivery cost for scaling up the COBRA intervention in Bangladesh would be only 0.60 US dollar or equivalent to Tk 51 per patient annually.
Dr John David Clemens, executive director, iccdr,b said, “The implemented strategies in the COBRA-BPS trial have the potential to offer sustainable and low cost solutions for effective blood pressure lowering that can be integrated in the public healthcare systems in Bangladesh and other South Asian countries, and could save thousands of lives.”
The study was funded by the Joint Global Health Trials scheme, which includes the Medical Research Council, the UK Department for International Development (DFID), National Institute for Health Research (NIHR) and the Wellcome Trust.