Oxford Vascular Study
- 01865 231601 (fax 01865 234629)
Founded in 2002
Over 200 research papers published
The Oxford Vascular Study (OxVasc) investigates vascular diseases (e.g. strokes, heart attacks) in patients registered with eight general practices in Oxfordshire. We run a rapid-access clinic for patients with suspected Transient Ischaemic Attacks (TIAs) or minor strokes.
What is the purpose of the study?
The purpose of the Oxford Vascular Study is to find out how common vascular disease (e.g. heart attacks, strokes, transient ischaemic attacks (TIA) and other circulatory problems) is in Oxfordshire, and how it affects people’s lives. The study is unique in the world in studying all these types of vascular disease at the same time and in the same population.Our aim is to improve understanding of these conditions, and how to better treat patients.
We have been recruiting patients with vascular diseases to OxVasc since 2002. The GP practices we work with refer patients suspected of suffering a TIA or minor stroke to our rapid-access clinic, where a specialist doctor will clinically assess the patient, and a range of investigations may be performed. Treatments, if necessary, will be initiated. Information is gathered as part of this clinical service in order to help answer our research questions. For patients who have had larger strokes necessitating admission to hospital, a member of our team will visit them to discuss joining the study.
After an initial assessment, we see patients at various stages up to 10 years after their event, to see how they are recovering, and to ensure they are on appropriate treatment for prevention of future strokes. By collecting information from patients over a long period of time, we can track how the need for healthcare is changing, both for individuals and the population as a whole. So far we have published over 200 academic papers with results of our research. Our findings have already changed how people are assessed and treated after a TIA or stroke, both in the UK and around the world.
Our research questions
The information we gather when we see patients is used both for optimising treatment and care, and to answer our research questions:
- How many people are having a stroke? Is the number rising or falling with time and why?
- Can we prevent patients from having a stroke with existing preventative strategies?
- Are there any biomarkers or genes that would identify people at greater risk of stroke or vascular cognitive impairment?
GP Practices working with oxvasc
- 19 Beaumont Street, Oxford
- Bartlemas Surgery, East Oxford Health Centre
- KEY Medical Practice, Kidlington and Yarnton
- The Malthouse Surgery, Abingdon
- Marcham Road Family Health Centre, Abingdon
- The Abingdon Surgery, 65 Stert St, Abingdon
- Berinsfield Health Centre, Berinsfield
- Church St Practice, Wantage
Examples of OxVasc Research
TIAs and Minor Strokes: Medical Emergencies
OxVasc took a different approach to the assessment and management of patients who had suffered a TIA or minor stroke. Historically, these events had been investigated with an appointment-based clinic assessment, and then treatment was initiated by the patient's GP. In the 'EXPRESS' study, we showed that by treating these events as medical emergencies, seeing patients rapidly, and initiating treatments urgently, 80% of early recurrent strokes could be prevented. In real terms, we showed that by employing the OxVasc strategy, 10,000 strokes per year could be prevented in the UK, saving the NHS £200 million per year in costs.
This work led directly to:
- A reduction in the recommended time allowed to assess and investigate patients with TIA and minor stroke from four weeks to 24 hours in UK guidelines.
- Department of Health strategy mandating NHS trusts to provide a daily TIA clinical service modelled on that established by OxVasc.
Major international guidelines have also endorsed the findings of OxVasc.
The ABCD2 Score
The ABCD2 was derived from data collected as part of the Oxford Vascular Study. It is a simple clinical tool based on easily assessable risk factors, which is of use for calculating an individual's early risk (up to 90 days) of stroke after they have suffered a TIA, and can therefore guide appropriate management. Use of the ABCD2 score is recommended in NICE guidelines for TIA and stroke.
Blood Pressure Variability
OxVasc has shown how the variation in patient blood pressure, independent of average blood pressure, is a predictor for risk of vascular events; greater variation confers greater risk. Given this finding, we investigated the effects of different classes of blood pressure medication upon variability, discovering that certain classes are better at controlling blood pressure variation.
Current clinical guidelines are being revised and should take these findings into account. The UK stroke association has said “this work will have a huge impact on the future prevention of strokes”, and the accompanying commentary to our Lancet papers said “Rothwell and colleagues are to be congratulated on bringing forth compelling findings that set the foundation for major change in our practice of blood pressure treatment for the prevention of stroke and other cardiovascular diseases.”