Modelling Of Clinic And Ambulatory Blood Pressure On Cardiovascular Risk And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$133,957.00
Summary
Whilst ambulatory blood pressure monitoring data has been shown to be a good predictor of cardiovascular events, there remains controversy as to its utility in clinical practice. This project will use data from existing population and clinical cohort studies to examine the role of ambulatory blood pressure in risk assessment and hypertension management in Australia and around the globe. The findings are likely to have a major impact on clinical guidelines for hypertension management.
Understanding The Origins Of Neurogenic Hypertension
Funder
National Health and Medical Research Council
Funding Amount
$668,914.00
Summary
Brain cells that control the cardiovascular system are thought to have stopped dividing by adulthood. We recently discovered that this is not the case. Our initial findings suggest that these nascent cells might be important for maintaining normal blood pressure. This work will allow us to elucidate the function of these nascent cells and how they integrate into the circuit that controls the cardiovascular system. Our findings will be fundamental for understanding diseases such as hypertension.
Central Aortic Blood Pressure In Children: Establishing A Gold Standard Non-invasive Assessment Of Cardiovascular Risk
Funder
National Health and Medical Research Council
Funding Amount
$694,342.00
Summary
The best way of assessing early risk of cardiovascular disease involves measuring blood pressure near the heart (central pressure), but existing devices used in adults for this purpose are inaccurate in children. We will develop a children-specific method and apply it to study early cardiovascular risk in a comprehensive health study of 2000 children Australia-wide. We will also investigate why children with congenital heart disease frequently develop ‘older-adult’ heart disease at a young age.
INTroducing A Care Bundle To Prevent Pressure Injury (the INTACT Trial)
Funder
National Health and Medical Research Council
Funding Amount
$1,093,250.00
Summary
In Australia, hospital acquired pressure injuries (i.e. bedsores) range from 7.4% – 17.4%. A care bundle is a structured group of interventions associated with improved patient outcomes. The aim of this 3-year cluster randomised controlled trial is to provide rigorous evidence regarding the effect of a patient centred pressure injury prevention care bundle on the development of pressure injuries in patients at risk of developing a hospital acquired pressure injury.
Optimising Non-invasive Ventilation At Birth For Preterm Infants
Funder
National Health and Medical Research Council
Funding Amount
$735,912.00
Summary
Infants born very premature require respiratory support at birth to make the transition to newborn life. As these infants are very immature and prone to injury, modern respiratory care strategies utilise the least invasive approaches mainly applied using a facemask. However, we have discovered that the larynx is closed at birth and thereby prevents air from entering the lung. This application is focussed on optimising the efficiency of facemask ventilation at birth and stimulating breathing.
Sympathetic Control Of Cutaneous Blood Flow And Blood Pressure In Human Spinal Cord Injury
Funder
National Health and Medical Research Council
Funding Amount
$242,002.00
Summary
While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracol ....While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracolumbar segments. Complete decentralization can result in autonomic dysreflexia (autonomic hyperreflexia), in which sensory stimuli originating below the lesion evoke a reflex increase in sympathetic drive to the blood vessels, causing them to constrict. Because of this, blood pressure may rise suddenly and remain at such high levels that stroke and (occassionally) cardiac arrest may occur. This phenomenon, autonomic dysreflexia, is considered a medical emergency. The typical subjective signs of autonomic dysreflexia include a throbbing headache, tingling in the head or nasal congestion; sweating and flushing above the lesion are clinical signs that prompt medical staff to measure blood pressure and to locate the source of sensory irritation (usually a distended bladder or impacted colon, sometimes a pressure sore or ingrown toenail). Commonly, however, subclinical episodes go undetected, and this phenomenon of silent dysreflexia is of increasing concern. This project will develop means of assessing the integrity and state of the sympathetic nervous system below a lesion in patients with spinal cord injury and characterize the firing properties of reflexly activated sympathetic neurones.Read moreRead less
Treating Insomnia Co-morbid With Obstructive Sleep Apnoea: A Randomized Controlled Clinical Effectiveness Trial.
Funder
National Health and Medical Research Council
Funding Amount
$600,869.00
Summary
Obstructive Sleep Apnoea (OSA) is a common but serious sleep disorder. Continuous positive airways pressure (CPAP) therapy can be very effective in treating OSA. We have found that many patients with OSA also suffer from insomnia, and this can make it hard for them to begin CPAP therapy and hard for them to stick to it. This trial will examine the effect of treating insomnia concurrently with CPAP, with the expectation that overall treatment outcomes will improve.
The Effects Of Tonic Muscle Pain On The Sympathetic And Somatic Motor Systems In Human Subjects
Funder
National Health and Medical Research Council
Funding Amount
$462,948.00
Summary
The main objective of this proposal is to reveal the effects of nociceptive reflexes in humans, and thus identify their functional and clinical implications. By performing invasive recordings from the nerves that control blood vessels and muscles in healthy volunteers subjected to long-lasting (~1 hour) experimental pain, this work will increase our understanding of the adaptive changes that pain induces and improve treatments to prevent pain from becoming chronic.
FUNCTIONAL IMAGING OF THE BRAINSTEM AND CORTICAL SITES OF BLOOD PRESSURE CONTROL IN HUMAN SUBJECTS IN HEALTH AND DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$398,498.00
Summary
Disturbances in cardiovascular control underpin many diseases yet little is known about how the brain controls the heart and blood vessels. This project uses brain imaging (fMRI) and concurrent nerve recording in awake human subjects to increase our understanding of how normal blood pressure is maintained and how different disease states influence this control.
Pressures Exerted On Upper Airway Walls By Surrounding Tissue Structures
Funder
National Health and Medical Research Council
Funding Amount
$426,500.00
Summary
The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open a ....The obstructive sleep apnoea syndrome (OSA) refers to a condition in which throat blockage occurs during sleep leading to breathing difficulties, including cessation of breathing for short periods of time. OSA effects both men and women but is amongst the commonest of chronic disorders of adult males, occurring in 5% of men over the age of 45 years. In the proposed studies we will examine the effect of the pressure in the tissues surrounding the throat on the ability of the throat to stay open and allow breathing. The major outcome of the animal studies is increased knowledge concerning mechanisms whereby collapsing forces are applied to the upper airway. This will give insights into potential factors influencing upper airway collapse during sleep in OSA patients. Of particular importance will be our studies on the effects of jaw position on the pressure exerted on the walls of the throat since the use of an intra-oral device to hold the jaw forward during sleep is one of the treatments used to prevent throat blockage during sleep. The studies in humans will examine, for the first time, the notion that the mass (weight) of the neck has a direct effect on the severity of sleep disordered breathing. If neck mass has a substantive influence on sleep disordered breathing then strategies aimed at reducing neck mass (fat) may provide a new therapeutic approach to the management of OSA patients.Read moreRead less