A Randomised Trial Of The Effects Of Cholesterol Lowering Therapy Among Patients With Chronic Renal Impairment
Funder
National Health and Medical Research Council
Funding Amount
$333,250.00
Summary
People with kidney disease are well known to be at high risk of developing major health problems earlier in life than people without kidney problems. In particular, people with kidney disease are more likely to suffer from heart attacks and strokes. For a number of other high-risk patient groups (such as people with heart disease), studies have clearly shown that cholesterol-lowering treatment can significantly reduce the risks of serious complications. However, until now, patients with kidney d ....People with kidney disease are well known to be at high risk of developing major health problems earlier in life than people without kidney problems. In particular, people with kidney disease are more likely to suffer from heart attacks and strokes. For a number of other high-risk patient groups (such as people with heart disease), studies have clearly shown that cholesterol-lowering treatment can significantly reduce the risks of serious complications. However, until now, patients with kidney disease have generally been excluded from such studies because of concerns about drug side effects. New, better-tolerated cholesterol lowering drugs now offer an opportunity to see if this highly effective treatment is also protective among people with kidney disease. The HARP (Heart And Renal Protection) trial is a large new study that will be done as a collaboration between Australian researchers and researchers from the University of Oxford in the UK. The aim of the study is to see if low doses of two cholesterol-lowering drugs can reduce the risks of stroke and heart attack. The study will include about 9,000 people with chronic kidney disease followed for an average of 4 years. It is hoped that by using low doses of two treatments, rather than a high dose of one, it will be possible to get substantial benefits without side effects. There are presently many tens of thousands of individual in Australia with chronic kidney disease and many millions of such individuals worldwide. The results of the HARP study will therefore influence the care of a very large number of people. If the results were positive, implementation of this new treatment would be expected to prevent many tens of thousands of premature strokes and heart attacks around the world each year.Read moreRead less
Assessing Cardiovascular Disease (CVD) Risk In Aboriginal People
Funder
National Health and Medical Research Council
Funding Amount
$73,550.00
Summary
Aboriginal Australians have higher death rates from cardiovascular disease (CVD) than other Australians, with rates in young and middle aged people increased 15-fold or more. A multi-factor approach, which considers all the risk factors, is the best strategy to identify and reduce CVD risk. The first step for selection of risk-reduction therapy in an individual is to assess his-her risk status and the benefit of intervention. Several risk assessment tools, incorporating traditional risk factors, ....Aboriginal Australians have higher death rates from cardiovascular disease (CVD) than other Australians, with rates in young and middle aged people increased 15-fold or more. A multi-factor approach, which considers all the risk factors, is the best strategy to identify and reduce CVD risk. The first step for selection of risk-reduction therapy in an individual is to assess his-her risk status and the benefit of intervention. Several risk assessment tools, incorporating traditional risk factors, have been developed from Western populations. They would be most appropriately applied to individuals who resemble the study sample; their validity in Aboriginal Australians has not been evaluated and no risk prediction formulae have been developed specifically for Aboriginal people. Recent reports suggest that a variety of other non-traditional risk factors also influence CVD risk, including markers of central fat deposition, inflammation, nutrition, alcohol use and early growth. Given the disadvantaged circumstances of many Aboriginal people, it is likely that some of the factors are influencing their CVD risk. The applicants have collected baseline risk factor data on volunteers in one Aboriginal community and followed their course, including CVD deaths and CVD hospitalisations, for more than a decade. From this baseline information, which goes beyond traditional risk markers, and from additional measures like birthweight, and markers of inflammation and nutrition assayed in retrieved serum, we will develop a variety of models for predicting a CVD risk in this group. We will also lay plans to evaluate these tools in other Aboriginal groups. A better understanding of the causes of CVD in this population is important to influence public health policy for CVD prevention. The models will be helpful health education tools at the community level and will allow therapeutic or lifestyle intervention in individuals to be targeted at their individual risk profile.Read moreRead less
The LIPID Study: 16 Year Outcomes And Predictors Of Risk And Their Interactions In CHD Patients
Funder
National Health and Medical Research Council
Funding Amount
$756,559.00
Summary
The single most common cause of cardiovascular disease, including heart attack and stroke, is hardening of the arteries. This can largeley be prevented and this research seeks to expand our knowledge of new indicators of risk and their interaction with the traditional risk factors, such as smoking. With increased understanding, it is very possible that novel factors will be discovered which will lead to very important new treatments to prevent problems like heart attack in the future.
Investigating The Origin Of Obesity-induced Dyslipidaemia
Funder
National Health and Medical Research Council
Funding Amount
$332,798.00
Summary
This project will investigate a possible mechanism to explain why it is that obese and diabetic individuals often have a typical type of abnormal fats in the blood particularly elevated triglycerides. If this theory is confirmed it may lead to new targets for improving abnormal lipids in these conditions.
Roles Of Brain-derived Neurotrophic Factor In The Regulation Of Blood Pressure
Funder
National Health and Medical Research Council
Funding Amount
$299,625.00
Summary
Brain-derived neurotrophic factor (BDNF) is an extraordinary neurotrophin which acts not only as a classical neurotrophic factor to promote neuronal survival and differentiation but also as a neuromodulator to modulate nerve activity. Recently, we found that injection of exogenous BDNF into brain stem triggers a significant increase in blood pressure. The present proposal is to test the hypothesis that BDNF is a physiological neuromodulator regulating blood pressure. The aim of this study is to ....Brain-derived neurotrophic factor (BDNF) is an extraordinary neurotrophin which acts not only as a classical neurotrophic factor to promote neuronal survival and differentiation but also as a neuromodulator to modulate nerve activity. Recently, we found that injection of exogenous BDNF into brain stem triggers a significant increase in blood pressure. The present proposal is to test the hypothesis that BDNF is a physiological neuromodulator regulating blood pressure. The aim of this study is to analyse physiological roles of BDNF in the brains stem and spinal cord in the regulation of nerve activity and blood pressure. The successful execution of the project will significantly enhance our understanding of how blood pressure is controlled by BDNF and nerve activity. The knowledge from this study will form basis for designing new drugs to control high blood pressure.Read moreRead less
Early Retinal Vessel Changes In Diabetes And The Metabolic Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$212,500.00
Summary
Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the re ....Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the relationship of microvascular disease in the retina (at the back of the eye) to diabetes, pre-diabetes status and diabetes complications. We will use a computer-imaging technique to measure the diameters of retinal blood vessel from digital photographs taken in 2,177 participants of the 1999-2000 Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, a community-based survey of people aged 25 years and older examining risk factors and complications of diabetes. In the proposed study, we aim to answer the following questions: 1) Are changes in the retinal blood vessel diameter (e.g., narrowed or dilated vessels) associated with diabetes and pre-diabetes? 2) Are these retinal vessel changes related to obesity, high blood pressure and high lipid levels? 3) Are retinal vessel changes related to diabetes complications, such as heart disease, kidney disease, nerve problems and foot ulcers? 4) Do retinal vessel diameter changes predict people who will subsequently develop diabetes, irrespective of their risk factor profile? Using this well-characterized population, and existing digital retinal photographs, the proposed study will offer a unique and cost-effective opportunity to address important gaps in our understanding of how diabetes and pre-diabetes develop, and whether they are related to microvascular diseases. This may ultimately lead to new treatment and preventive approaches targeted at the small blood vessels in the body.Read moreRead less
Biomarkers And Genetic Determinants Of Cardiovascular Risk In Diabetes: The FIELD Study
Funder
National Health and Medical Research Council
Funding Amount
$1,961,718.00
Summary
The patient characteristics and blood factors determining the risk of heart attack, stroke, kidney and eye disease in people suffering from diabetes are not well understood. The FIELD Study, by analysing these characteristics and many blood factors hopes to shed light on ways to prevent these complications for future patients. The project proposes to measure factors on blood samples collected on more than 9000 patients with diabetes and analyse these over the next three years. It hopes to help d ....The patient characteristics and blood factors determining the risk of heart attack, stroke, kidney and eye disease in people suffering from diabetes are not well understood. The FIELD Study, by analysing these characteristics and many blood factors hopes to shed light on ways to prevent these complications for future patients. The project proposes to measure factors on blood samples collected on more than 9000 patients with diabetes and analyse these over the next three years. It hopes to help doctors identify patients who are at particular risk of complications for special attention and early treatment.Read moreRead less
A Randomised Study Of Insulin/dextrose Infusion For Myocardial Infarction In Patients With Diabetes.
Funder
National Health and Medical Research Council
Funding Amount
$181,018.00
Summary
In Australia, some 5-10% of the population have diabetes, and the prevalence is rising. Some 50% of diabetics over the age of 40 will die from cardiovascular disease, and the cardiac mortality amongst patients with diabetes is 3 times that of the general population. One quarter of patients admitted to hospital in Australia with myocardial infarction (heart attack) have diabetes. Myocardial infarction (AMI) is much more likely to be fatal for a person with diabetes, and the mortality rate after o ....In Australia, some 5-10% of the population have diabetes, and the prevalence is rising. Some 50% of diabetics over the age of 40 will die from cardiovascular disease, and the cardiac mortality amongst patients with diabetes is 3 times that of the general population. One quarter of patients admitted to hospital in Australia with myocardial infarction (heart attack) have diabetes. Myocardial infarction (AMI) is much more likely to be fatal for a person with diabetes, and the mortality rate after one year is about double that of the non-diabetic population. Whilst considerable advances have been made in recent years in reducing the mortality from AMI, there have been few studies with the specific aim of optimising management for patients with diabetes in this situation. One recent study (the DIGAMI Study) however, examined the use of insulin-dextrose infusion therapy at the time of AMI for patients with diabetes and found a significant reduction in mortality rate amongst treated patients. However, due to the design of the study, it is not possible to determine if it was the insulin-dextrose infusion which resulted in the reduced mortality, or if it was one of a number of confounding variables. Nonetheless, the DIGAMI Study has raised the possibility that insulin-dextrose infusion will improve the outcome for diabetics, and theoretically, there are good reasons that this may provide a real benefit, via a reduction in free fatty acids, which may potentiate damage to the heart. Our study aims to determine if insulin-dextrose infusion therapy improves the prognosis of diabetic subjects with AMI. This will be performed as a randomised controlled trial across 4 teaching hospitals. If its benefit are confirmed, then this will have significant implications for the management of diabetics with AMI, as insulin-dextrose infusions are not currently routine, especially for patients with lower levels of hyperglycaemia.Read moreRead less
UNLOCKING GENETIC FACTORS PREDICTING TYPE 2 DIABETES COMPLICATIONS FOR CLINICAL PRACTICE: THE FIELD STUDY
Funder
National Health and Medical Research Council
Funding Amount
$2,503,122.00
Summary
Heart disease, stroke, eye and kidney diseases in diabetes have both environmental and genetic predispositions. With over 5000 Australians with diabetes, this research in the FIELD study is to identify the important genetic contributors to these complications. It will explore how the genetic features cause disease and whether the most important ones can be screened for in simple blood tests. It will also examine whether the genetic damage of ageing is accelerated in diabetes.
Maintaining And Developing The Health In Men Study
Funder
National Health and Medical Research Council
Funding Amount
$403,014.00
Summary
The aim of this study is to improve our understanding of healthy aging in older men. The outcomes we are interested in include common acute medical problems such as heart attacks or stroke, chronic debitilating problems such as dementia or heart failure and psycho-social challenges of ageing such as depression and isolation. We have been studying a group (4,250) men for nearly a decade. These men have provided us with a large amount of information about their background, life style and health an ....The aim of this study is to improve our understanding of healthy aging in older men. The outcomes we are interested in include common acute medical problems such as heart attacks or stroke, chronic debitilating problems such as dementia or heart failure and psycho-social challenges of ageing such as depression and isolation. We have been studying a group (4,250) men for nearly a decade. These men have provided us with a large amount of information about their background, life style and health and we are now following them to see what predicts the outcomes of interest. This research is important because the proportion of the population aged 75 years and over is expanding rapidly. Although we know a lot about predictors of health and illness in middle age, we know surprisingly little about these things in the elderly. This research aims to answer some of these questions.Read moreRead less