Collaborative Overview Of Cohort Studies Of Cardiovascular Diseases In The Asia Pacific Region
Funder
National Health and Medical Research Council
Funding Amount
$230,388.00
Summary
Throughout Asia and the Pacific, cardiovascular diseases are now a leading cause of death and disability. However, most information about the causes of these diseases comes from studies conducted in North America and Europe, and there are few data available from the Asia Pacific region. Because patterns of cardiovascular diseases and levels of risk factors are very different in the West and East, it is possible that important differences exist in the relative contribution of different factors to ....Throughout Asia and the Pacific, cardiovascular diseases are now a leading cause of death and disability. However, most information about the causes of these diseases comes from studies conducted in North America and Europe, and there are few data available from the Asia Pacific region. Because patterns of cardiovascular diseases and levels of risk factors are very different in the West and East, it is possible that important differences exist in the relative contribution of different factors to disease occurrence in different regions. For example, an earlier project, from which the current study evolved, demonstrated that the association of blood pressure with stroke was about two times steeper in China and Japan than in the West. The present project has been initiated to further investigate the causes of common cardiovascular diseases in populations of the Asia Pacific region. It will involve more than 40 studies conducted in at least 9 countries from the region. These studies include more than 500,000 individuals followed for an average of 8-9 years. Data from 30 studies involving 450,000 individuals has already been provided to the applicants. Analyses will be conducted to provide region-, age-and sex-specific estimates of the effects various risk factors on several types of cardiovascular diseases. The risk factors of interest include: blood pressure, total cholesterol and its subfractions, triglycerides, diabetes, obesity, alcohol consumption, occupation and education. In addition to providing more precise estimates of the effects of established risk factors such as blood pressure, this project will, provide new data on several other risk factors not well investigated in this region. The results should be of importance in determining priorities for cardiovascular disease prevention. They should also be of relevance for predicting changes in the extent of the cardiovascular disease epidemics facing countries in the region.Read moreRead less
The Blood Pressure Lowering Treatment Trialists' Collaboration
Funder
National Health and Medical Research Council
Funding Amount
$166,250.00
Summary
Treatments that lower blood pressure are well known to reduce the risk of heart attack and stroke, and several different classes of blood pressure lowering drug are now widely used. While all the main classes of drug offer protection against serious complications, it is possible that one drug class may be better than the others. However, whether this is so remains uncertain and cannot be reliably determined by any one single study. The Blood Pressure Lowering Treatment Trialists' Collaboration i ....Treatments that lower blood pressure are well known to reduce the risk of heart attack and stroke, and several different classes of blood pressure lowering drug are now widely used. While all the main classes of drug offer protection against serious complications, it is possible that one drug class may be better than the others. However, whether this is so remains uncertain and cannot be reliably determined by any one single study. The Blood Pressure Lowering Treatment Trialists' Collaboration is a large international project led by a group of Australian researchers based at the Institute for International Health in Sydney. The aim of the project is to systematically gather together sufficient information from large-scale studies to make it possible to answer important outstanding questions about the effects of different classes of blood pressure lowering drugs on major outcomes, such as heart attack and stroke. The Collaboration includes many of the leading blood pressure researchers from around the world and will combine data from more than 30 trials and over 200,000 individuals. On the basis of the overview results it should be possible to provide doctors with important new information about the best blood pressure lowering treatment for their patients. A previous review of the effects of blood pressure drugs completed by the same group was published in The Lancet in 2000, and has been an important aid to many professional and regulatory groups in the year since. Reliable information about the effects of different classes of blood pressure lowering drugs is of great importance. Even if differences between the effects of different classes of drug are small, the implications for the prevention of blood pressure-related complications would be substantial because of the very large numbers of people taking them, worldwide. This collaborative overview project offers a unique opportunity to provide the most reliable and up-to-date information on the subject.Read moreRead less
This study will provide highly reliable information about the use of tight blood glucose control in critically ill patients. It involves an international collaboration between opinion leaders in this field and uses sophisticated statistical methods to combine data from all the clinical trials in this area. The study will clarify many of the current clinical questions about tight glucose control during critical illness, informing practice guidelines in Australia and around the world.
Blood Pressure Lowering In Patients With Chronic Kidney Disease: Evidence From Prospectively Planned Overview Analyses
Funder
National Health and Medical Research Council
Funding Amount
$257,271.00
Summary
This study will provide highly reliable information about the best way of managing blood pressure in people with chronic kidney disease. It will use sophisticated methods to summarize information from 25 large clinical trials and 160,000 participants to determine whether lowering blood pressure reduces the risk of heart disease and further kidney damage.The study will also determine whether currently recommended blood pressure drugs are those which will provide the most benefit.
Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less
A Practical New Method Of Measuring Population Salt Intake
Funder
National Health and Medical Research Council
Funding Amount
$327,193.00
Summary
The World Health Organization has set a target for member countries to reduce salt intake by 30% by 2025. Key to this is measurement of population salt intake. Collection of 24-hour urine samples is the gold standard used to estimate salt intake but this method is burdensome. Collection of a single urine sample is an alternative method. This project will bring together all of the available data worldwide to assess the reliability of using a single urine sample to measure population salt intake.
This fellowship will allow the applicant to continue to study the major musculoskeletal diseases in Australia (osteoarthritis, osteoporosis and rheumatoid arthritis) using a combination of observational and interventional studies.