Characterisation Of The Morning Surge Of Blood Pressure As A Risk Factor For Cardiovascular Disease.
Funder
National Health and Medical Research Council
Funding Amount
$399,450.00
Summary
Cardiovascular events occur more frequently in the early morning transition between the asleep and awake state. This parallels the period where the rise in blood pressure and heart rate is at its greatest and hence may be a potential risk marker for cardiovascular events. We have developed a new mathematical way of measuring the morning surge in blood pressure and heart rate in patients using ambulatory monitoring which has been patented. The main aim of the grant is to determine if morning bloo ....Cardiovascular events occur more frequently in the early morning transition between the asleep and awake state. This parallels the period where the rise in blood pressure and heart rate is at its greatest and hence may be a potential risk marker for cardiovascular events. We have developed a new mathematical way of measuring the morning surge in blood pressure and heart rate in patients using ambulatory monitoring which has been patented. The main aim of the grant is to determine if morning blood pressure surge is a risk factor and to determine the underlying mechanisms. Using both clinical and experimental studies we aim to a) characterise the rate of morning rise in hypertension and normotension b) determine whether subjects with an exaggerated morning surge in blood pressure also have an over responsive nervous system, c) determine whether the rate of rise in blood pressure is a risk factor and d) determine in stroke prone animals whether preventing the waking blood pressure surge is beneficial. This will be achieved via a novel analysis method of continuous BP recording over the 24hr period. These studies are important since identification of new risk markers or predictors of sudden cardiac death, stroke and myocardial infarction is a national health priority. Understanding the mechanisms that are responsible for the increased risk of a cardiovascular event in the morning is the first step to devising appropriate treatment and risk management. Our study will shed light on both the mechanism and the therapy aspects.Read moreRead less
Determinants Of Cardiovascular Health Over The Lifecourse In A Population-based Cohort Study Of Australian Families
Funder
National Health and Medical Research Council
Funding Amount
$92,161.00
Summary
This unique project will examine the heart health of roughly 3500 11-12 year olds in Australia's only nationally-representative children's study. It will then examine factors that may contribute to differing heart disease progression. We will characterise established factors (such as cholesterol, blood pressure and diabetes), as well as measures of infection burden and inflammation to examine the innovative theory that childhood infection and/or its treatment contribute to poorer heart health.
MECHANISMS OF CEREBROVASCULAR REGULATION IN HEALTH AND DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$216,430.00
Summary
Failure of the cerebral circulation to meet the brain's immediate high nutritive requirements results in stroke in just a few minutes. Stroke continues to be a major cause of death and disability, and this major medical challenge requires urgent and significant research at the basic level to better understand mechanisms of normal, and then abnormal, regulation of cerebral artery function. The project will examine the importance of a novel mechanism in regulating brain blood flow by affecting the ....Failure of the cerebral circulation to meet the brain's immediate high nutritive requirements results in stroke in just a few minutes. Stroke continues to be a major cause of death and disability, and this major medical challenge requires urgent and significant research at the basic level to better understand mechanisms of normal, and then abnormal, regulation of cerebral artery function. The project will examine the importance of a novel mechanism in regulating brain blood flow by affecting the degree of opening of the cerebral arteries. This mechanism involves activation of an enzyme, Rho-kinase, which is present in the wall of blood vessels. The applicants believe that this process plays an important role in the normal, healthy regulation of blood supply to the brain. Moreover, there are strong reasons for us to speculate that the function of this enzyme is abnormally high in two disease states that are associated with an increased risk of stroke - high blood pressure and subarachnoid haemorrhage. We will employ a variety of techniques to assess the importance of Rho-kinase in cerebral artery function in the living body, and also in isolated segments of artery. The results are expected to provide major new insight into mechanisms that regulate brain blood flow, and the knowledge gained here may lead to better therapies to prevent or treat stroke.Read moreRead less
Monitoring cardiovascular risk is a major part of the clinical workload both in general practice and specialty areas, but it is an under-researched area, reflected in a general lack of evidence based guidelines. My research will evaluate how to optimise the monitoring of cardiovascular risk both before and after starting treatment. By maximising clinical benefits for patients and minimising unnecessary resource use, my research will benefit patients, clinicians and the community at large.
Personalised Exercise As Medicine. Optimising The Prescription To Maximise The Benefit
Funder
National Health and Medical Research Council
Funding Amount
$772,490.00
Summary
Humans have never been less physically active than in contemporary Western society. These studies will provide an evidence-basis to address the inactivity epidemic by laying the foundation for personalised and effective exercise prescriptions, to which people are more likely to adhere.
An Implementation Trial Of A Telephone-based Care Management Program For Patients Following Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$641,656.00
Summary
We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such progra ....We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such programs due to transport and many other barriers. So, there is an urgent need to identify new, effective, and affordable ways of delivering cardiac rehabilitation programs to people after a heart attack. The proposed telephone-delivered program will be particularly appropriate for disadvantaged people, such as those living in rural and remote areas as well as Indigenous Australians, who do not currently have access to hospital-based cardiac rehabilitation programs. People who have had a heart attack will be recruited from three of Brisbane's largest public teaching hospitals, and will then be randomly assigned to the telephone-delivered cardiac rehabilitation program (Care Management Intervention group) or to a control or Usual Care group. The Care Management Intervention group will receive regular telephone calls from a highly qualified 'Care Manager' based at the renowned National Heart Foundation of Australia telephone support service, 'Heartline'. The Care Manager will help people to manage their heart condition and prevent the reoccurrence of further heart problems. People will also be encouraged to make necessary lifestyle and behavioural changes with the assistance of the Care Manager and some Heart Foundation educational and interactive resources to record their progress. We expect that the program or Care Management Intervention group will have better health outcomes than the control or Usual Care group at 6 and 12 months follow up.Read moreRead less
The AMP-activated protein kinase (AMPK) is a metabolic stress-sensing enzyme responsible for matching energy supply to energy demand by the many different cells in our bodies. AMPK is active in the heart, where it may control cardiac function and the response of the heart to disease. It has been difficult to study AMPK in the heart because we lack drugs that block the actions of AMPK. This study will investigate the role of AMPK in the heart using a genetic approach whereby the AMPK enzyme is re ....The AMP-activated protein kinase (AMPK) is a metabolic stress-sensing enzyme responsible for matching energy supply to energy demand by the many different cells in our bodies. AMPK is active in the heart, where it may control cardiac function and the response of the heart to disease. It has been difficult to study AMPK in the heart because we lack drugs that block the actions of AMPK. This study will investigate the role of AMPK in the heart using a genetic approach whereby the AMPK enzyme is rendered inactive (a gene knockout approach). By this approach we will learn how AMPK controls heart function and how drugs that affect AMPK may impact on the heart.Read moreRead less