icddr,b scientists with international collaborators win major research grant to tackle hypertension

The new study is funded by the joint global health trials scheme, a partnership of DFID, the Medical Research Council and The Wellcome Trust, which aims to generate new knowledge about interventions to improve health in low and middle income countries that can be quickly implemented.

Hypertension, or high blood pressure, is a major risk factor for cardiovascular disease that is often under-recognised in developing countries. This growing epidemic is a particular problem in South Asia, where people tend to get heart disease at a younger age, causing a greater loss of productive years of life and serious economic consequences for the developing countries in the region. Lowering blood pressure is considered to be the single most important way to avert heart disease.

Scientists with icddr,b’s non-communicable diseases programme and their international collaborators have received a large award worth US$3 million to study ways to lower blood pressure in adults living in rural South Asia.The study will test low-cost public health strategies by health workers and doctors to lower blood pressure in a trial called COBRA-BPS trial (Control of Blood Pressure and Risk Attenuation – Bangladesh, Pakistan and Sri Lanka). The study, led by principal investigator Professor Tazeen Jafar from the Duke-National University of Singapore (DUKE-NUS) Graduate Medical School, will examine 2500 individuals in 30 rural communities in these three countries over a period of three years.

These strategies include providing education in patients’ homes about lowering their blood pressure through diet and exercise, improving referrals to trained doctors using simple checklists, training doctors and nurses in management of hypertension including the use of low-cost medicines, and counters at health clinics to provide tailored assistance for patients with high blood pressure. The researchers will compare these strategies to those provided in regular healthcare to determine if they lower blood pressure among individuals with hypertension, and are cost-effective.

Dr Aliya Naheed, Associate Scientist at icddr,b and head of its Non-communicable Diseases programme, is the leader of the Bangladesh component of the study, says: “The Government of Bangladesh has recently committed to a new 6-year action plan on non-communicable diseases and the evidence generated from our study will guide adoption of cost effective action plans.”

Professor John D Clemens, Executive Director of icddr,b and a co-investigator on the new project says: “The strategies being evaluated 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.”

Non-communicable diseases account for 63% of global deaths (37 million annually and rising), with 80% occurring in low- and middle-income countries. In conjunction with the World Health Organization (WHO), all three South Asian countries have recently prioritised action on combating non-communicable diseases such as heart disease, and the study will provide important information for policymakers on specifically how to address rising rates of hypertension among their populations.

The COBRA-BPS trial has been funded by the UK Department of International Development (DFID), Medical Research Council and The Wellcome Trust through their Joint Global Health Trials Scheme.