Applied Research in Public Health
Work in this area in Oxford uses a variety of methods on large scale data to understand cardiovascular risk management during and post pregnancy.
An example of the work included in this theme is the BUMP1 clinical trial, which aimed to explore how the risk of high blood pressure in pregnancies could be reduced with self-monitoring blood pressure: high blood pressure during pregnancy is a significant contributor to maternal deaths.
Previous work suggests that just giving patients a blood pressure monitor alone does very little in terms of blood pressure control, but self-monitoring with additional support (such as an app, education, clinical or pharmacist review, or self-management) can make significant changes to BP control. But little was known about whether the same is true of pregnancy.
So the BUMP trial recruited over 3000 pregnant women across the UK, with equal number of study participants being randomly assigned to either to usual their care or their usual care + self-monitoring of blood pressure.
The research team (led by University of Oxford researchers, with colleagues from across the UK) gave women at higher risk of high-blood pressure problems with blood pressure monitors, and asked to them take 2 readings 3 times a week and report them via the study app. The app then provided feedback in line with guidance that pregnant women are usually given, about when they needed to act on high or low readings.
But the researchers found that unlike other populations, where supported blood pressure monitoring can improve health outcomes, supported blood pressure monitoring did not lead to earlier clinic-based detection of high blood pressure in pregnant women – there was no significant statistical difference between the women who received the usual care versus the women who received the usual care plus app supported blood pressure self-monitoring.
Chappell LC, Tucker KL, Galal U, et al. Effect of Self-monitoring of Blood Pressure on Blood Pressure Control in Pregnant Individuals With Chronic or Gestational Hypertension: The BUMP 2 Randomized Clinical Trial. JAMA. 2022;327(17):1666–1678. doi:10.1001/jama.2022.4726
Find out more about the work taking place at the Department of Primary Care Health Sciences, University of Oxford.