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
Risk Factors For Chronic Respiratory Diseases In Middle Age: 36-year Follow-up Of The Tasmanian Asthma Study
Funder
National Health and Medical Research Council
Funding Amount
$358,750.00
Summary
This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1 ....This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1961, is one of the worlds most important resources of such information. The probands, their parents (16,267) and siblings (21,044) were first investigated for respiratory problems in 1968. Subsequently, three follow-up surveys were carried out at ages 13 (1974), 20 (1981) and 31 (1992) on either the total or sub-samples of the probands. In 1992, the children and spouses of the probands were also surveyed. Information on all respiratory problems was collected in all the follow-ups, although the main focus of the TAS to date has been asthma. The probands are now reaching the age at which all CRD as a group are beginning to inflict an increasing disease burden, which will become greater in the next two decades. Hence, TAS now provides an ideal opportunity to examine the potential risk factors and natural history of and of CRDs using data collected to date and new data collected at age 43. Also, it will provide a platform for future studies to investigate the progression of CRDs in this cohort. Hence, we propose to carry out the 36 year follow-up of this cohort focusing on CRDs. This will provide important information for preventing chronic respiratory morbidity and disability in the future, which will be original and significant not only in Australia but also internationally.Read moreRead less
Asthma, Lung Function, Snoring And Passive Smoking In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
Respiratory diseases such as asthma, chronic obstructive airway disease, and sleep apnoea are common in the community, and asthma is becoming more and more common. These diseases are a major cause of morbidity, lost time from work, use of health and community resources and death. Using information collected by the Busselton Health Studies between 1966 and 2000, we will investigate some new epidemiological aspects of respiratory diseases. Some of the questions we will examine are: * How much more ....Respiratory diseases such as asthma, chronic obstructive airway disease, and sleep apnoea are common in the community, and asthma is becoming more and more common. These diseases are a major cause of morbidity, lost time from work, use of health and community resources and death. Using information collected by the Busselton Health Studies between 1966 and 2000, we will investigate some new epidemiological aspects of respiratory diseases. Some of the questions we will examine are: * How much more common has asthma become in the Busselton population? Has the increase been more pronounced in some groups than in others (eg younger people)? Have other respiratory diseases also become more common? * Is decline in FEV1 over time a more useful measure of lung health than a single FEV1 measurement? How is decline in FEV1 related to age and other factors such as asthma, smoking, chronic respiratory diseases and hay fever? * Do the following put people at increased risk of sleep apnoea: overweight, recent weight gain, smoking, heavy alcohol intake, respiratory illness, cardiovascular disease and use of sedatives? * Do non-smoking spouses of smokers suffer more respiratory illness than spouses of non-smokers? We expect that results from this study will increase our understanding of the causes and progression of respiratory diseases, and may eventually point to ways of reducing the burden of these diseases in the community. Since all the information needed has already been collected in the course of earlier health surveys, this study will be particularly cost-effective.Read moreRead less
Assessment Of The Impact Of Climate Variability On The Transmission Of Ross River Virus Disease
Funder
National Health and Medical Research Council
Funding Amount
$168,125.00
Summary
It is a significant scientific and public health issue to assess the potential impact of climate change on population health. As human-induced global climate change continues, questions about its possible consequences command increasing attention. Australia has a great level of climate variability. Climate zones extend from temperate areas into the tropics and the climate fluctuates over time. Also, it is predicted that Australia lies in the region where the climate pattern will be affected most ....It is a significant scientific and public health issue to assess the potential impact of climate change on population health. As human-induced global climate change continues, questions about its possible consequences command increasing attention. Australia has a great level of climate variability. Climate zones extend from temperate areas into the tropics and the climate fluctuates over time. Also, it is predicted that Australia lies in the region where the climate pattern will be affected most in the 21th century. However, little research has to date been conducted on the potential public health impact of climate variability and change in Australia. This project aims to assess the effect of climate variability on the transmission of Ross River virus infection and other vector-borne diseases which may yield important insights into the potential public health consequences of climate change.Read moreRead less
Concord Hormones And Ageing In Men Project (CHAMP)
Funder
National Health and Medical Research Council
Funding Amount
$1,780,887.00
Summary
Throughout life men have poorer health than women, a health difference that extends into old age. In Australia in 2001, life expectancy for a 65 year old man was 20% less than for a 65 year old woman (81.6 years for men and 85.2 years for women). The study proposed here will fill major gaps in knowledge about key health problems in older men. The study will be called CHAMP: Concord Hormones and Ageing in Men Project. As people grow older, health problems that cause loss of independence and reduc ....Throughout life men have poorer health than women, a health difference that extends into old age. In Australia in 2001, life expectancy for a 65 year old man was 20% less than for a 65 year old woman (81.6 years for men and 85.2 years for women). The study proposed here will fill major gaps in knowledge about key health problems in older men. The study will be called CHAMP: Concord Hormones and Ageing in Men Project. As people grow older, health problems that cause loss of independence and reduced quality of life become increasingly important. The term 'geriatric giants' is sometimes used to describe these disabling syndromes: falls and fractures, cognitive impairment and dementia, urinary incontinence, and poor mobility and functional dependence. CHAMP has been designed to investigate the causes of, and inter-relationships between, these geriatric syndromes in men. Reproductive hormones are responsible for the fundamental biological differences between men and women. Underpinning CHAMP is the idea that age-related changes in reproductive hormones play an important role in the development of the geriatric syndromes in older men. There have been numerous studies of oestrogen and health in older women but only limited research on testosterone and other reproductive hormones in older men. CHAMP will be the largest study of the geriatric syndromes in older men ever conducted. The study will inlvolve 2800 men aged 65 years and over recruited from the community around Concord Hospital in Sydney. These men will each spend 3 hours at the study centre, where they will have a comprehensive physical examination and tests for osteoporosis, muscle weakness, dementia and urinary problems, as well as blood tests. This will all be repeated 2 years later.Read moreRead less
Low-yield Cigarettes And Diminution Of Small Airways Lung Function In Long-term Smokers
Funder
National Health and Medical Research Council
Funding Amount
$209,500.00
Summary
The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The ....The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The concern is that adenocarcinoma of the lung, a type of lung cancer that is most common in the small peripheral airways, has increased in frequency. This could be because the low-yield cigarette, with reduced yields of nicotine as well as tar, is smoked more intensely by smokers to compensate for the low nicotine. By smoking more intensely, we mean taking larger and more frequent puffs, inhaling the smoke deeply into the lungs, and holding the breath before expiring. This method of smoking would result in more tar particles being deposited in the peripheries of the lung where adenocarcinoma is most common. Because cigarette smoking has been linked also with other structural changes in the small airways of the lung, resulting in obstruction of airflow, we will test whether smoking low-yield cigarettes is associated with greater obstruction of the small airways than is smoking higher-yield cigarettes. To test whether the mechanism is the method of smoking, we will carefully describe and quantify each subject's pattern of smoking including the deposition of smoke-like Technegas particles in the peripheral lung.Read moreRead less
A Case-cohort Study Of New Risk Factors For Cardiovascular Diseases In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$197,349.00
Summary
Cardiovascular diseases account for about half of all deaths and for considerable use of health care resources. While several risk factors for cardiovascular disease, such as smoking, high blood pressure, high cholesterol, overweight and diabetes, are well-established, these do not fully explain all cardiovascular disease. In recent years, some new potential risk factors for cardiovascular disease have been identified. This study aims to examine these new risk factors in an Australian population ....Cardiovascular diseases account for about half of all deaths and for considerable use of health care resources. While several risk factors for cardiovascular disease, such as smoking, high blood pressure, high cholesterol, overweight and diabetes, are well-established, these do not fully explain all cardiovascular disease. In recent years, some new potential risk factors for cardiovascular disease have been identified. This study aims to examine these new risk factors in an Australian population. Using information collected by the Busselton Health Surveys over the last 20 years, we aim to determine whether people who had these risk factors in 1978 were more likely to develop cardiovascular disease over the following years. Since all the information needed has already been collected in the course of earlier health surveys, this study will be particularly cost-effective. We expect that results from this study will increase our understanding of the causes of cardiovascular disease, and may suggest some simple tests to help identify those people who may be at higher risk of heart disease and most likely to benefit from intervention.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
Aetiology, Burden And Causal Pathways Of Acute Lower Respiratory Infections Using Population Linked Data
Funder
National Health and Medical Research Council
Funding Amount
$437,476.00
Summary
Lower respiratory, or chest infections, are a problem for many children. This project will investigate the impact of chest infections on hospitals and emergency departments, the viruses and bacteria that cause them, identify those children who are at an increased risk of having chest infections and investigate the impact of routine immunisations on specific types of infections. This project will greatly add to our understanding of chest infections so appropriate interventions can be developed.
Blue Mountains Cohort Study: Incidence Of Eye Disease, Hearing Loss And Other Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$813,250.00
Summary
The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examination ....The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examinations on medical history, ocular factors, vascular disease, smoking, diet, plus environmental and blood factors. The study aims to assess the impact of these sensory impairments on measures of dependence, quality of life, general health, age-related cognitive impairment, depression and on mortality. The study will be conducted in Katoomba on the cohort of residents from two postcode areas who originally attended the Blue Mountains Eye Study during the period 1992-4. Examinations will commence by May, 2002 and be completed by April, 2004. We hope to examine 2,032 of the original cohort of 3,654 people. This project will build on the data already collected by the Blue Mountains Eye Study, one of the most successful community surveys conducted in Australia. The 10-year follow-up period will provide increased statistical power and precision to assess the role of possible risk factors for eye disease already identified by the earlier baseline and 5-year studies of this population. The hearing component of the study will provide the first longitudinal data on hearing loss from a large older Australian population.Read moreRead less