Low-cost solution to hypertension

Staff Correspondent

21 February, 2020 12:00 AM printer

High blood pressure among hypertensive patients can be controlled through a low-cost health intervention carried out by community health workers in rural areas in South Asia particularly in Bangladesh, said a study.

The COBRA-BPS trial, co-conducted by icddr,b, Aga Khan University, Pakistan, the University of Kelanyia, Sri Lanka, and coordinated by Duke-National University of Singapore reveals the results of the research.

The study says regular home visits by community healthcare workers to monitor patients’ blood pressure (BP) along with lifestyle coaching to them could effectively control high blood pressure.

The findings of the tri-nation study are published in the prestigious New England Journal of Medicine on Thursday.

The multi-country Control of Blood Pressure and Risk Attenuation – Bangladesh, Pakistan, Sri Lanka (COBRA-BPS) study is a cluster randomised trial that evaluated the effectiveness of the multi-component intervention among 2,550 individuals with hypertension living in 30 rural communities in Bangladesh, Pakistan and Sri Lanka between 2016 and 2019.

Data suggest that programme delivery cost for scaling up the COBRA intervention in Bangladesh would be only 0.60 US dollar, equivalent to 51.00 Taka per patient annually.

In Bangladesh the trial was implemented by icddr,b in Munshiganj and Tangail districts among 895 hypertensive individuals in close collaborations with the NCD Control Programme of Directorate General of Health Services under the 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 health assistants referred patients with uncontrolled blood pressure to selected sub-district hospital where doctors treated those patients following a treatment protocol and mobilized supplies of anti-hypertensive drugs for the patients. The study is funded by the Joint Global Health Trials scheme, which includes the Medical Research Council, the UK Department for International Development (DFID), the National Institute for Health Research (NIHR) and the Welcome Trust. The COBRA-BPS study is led by Prof Jafar and her team at Duke-NUS Medical School.


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