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
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
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
EFFECT OF EBV AND HHV-6 LATENT INFECTION OR REACTIVATION ON MS ACTIVITY: A PROSPECTIVE CLINICAL COHORT STUDY
Funder
National Health and Medical Research Council
Funding Amount
$263,845.00
Summary
Multiple Sclerosis (MS) is a severely debilitating neurodegenerative disease, affecting over 16,000 Australians. There is a need to examine which factors drive the progression of this disease. We examine the role of two viral infections on MS activity. It has the potential to contribute to antiviral interventions that might prevent relapses and-or decrease the clinical progression of this debilitating disease.
It has been proposed that inflammation plays a major role in prostate cancer risk. We are well placed to test this hypothesis following up evidence from our MCCS and RFPCS studies of associations between inflammatory markers and prostate cancer risk. This proposed project may open for the first time opportunities for the prevention of prostate cancer.
Infections, Inflammatory Markers And Prostate Cancer Risk
Funder
National Health and Medical Research Council
Funding Amount
$731,217.00
Summary
Prostate cancer is the leading cancer for Australian men but apart from getting older and having a family history of prostate cancer we do not know what causes it and nothing can be done to prevent it. This project follows up recent suggestions that some prostate cancer might be due to infections by bacteria and viruses. We will look for evidence of infection in blood samples and prostate tissue that we have collected from men with prostate cancer and from controls without prostate cancer.
This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
The Predictors Of Prostate Cancer In The Melbourne Collaborative Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$358,457.00
Summary
In 1990 we set up a long-term study of diet and health. The aim was to measure diet and other risk factors in healthy people in order to see how they might affect future development of cancer. To do this we recruited 41,500 people aged 40 to 69, measured what they ate and drank, and collected information on other aspects of lifestyle, medical history, and family history of common diseases. All had height and weight and blood pressure measured and gave a blood sample. People were selected so that ....In 1990 we set up a long-term study of diet and health. The aim was to measure diet and other risk factors in healthy people in order to see how they might affect future development of cancer. To do this we recruited 41,500 people aged 40 to 69, measured what they ate and drank, and collected information on other aspects of lifestyle, medical history, and family history of common diseases. All had height and weight and blood pressure measured and gave a blood sample. People were selected so that men and women and migrants from Italy and Greece would be included. In this way we could widen the range of dietary habits, other lifestyle factors and genetic variation (measured in DNA from blood). Since then participants have completed another questionnaire and instances of disease have been noted from self reports and from examining medical records. We want to analyse data from 700 men in the study who have developed prostate cancer (PC). First we will analyse data collected on all 17,000 men (collected when joining the study, and at follow up). Next we will use data from only the 700 men with PC and 1400 men who have not developed PC. This study will focus on measuring substances in the blood. We want to measure a range of fats, vitamins, antioxidants and phytoestrogens, as well as male sex hormones and related substances. In the DNA from the blood we plan to measure variations in genes that influence how male sex hormones and other growth factors important in the prostate are produced and used. We will then be able to estimate what affect these factors have on the risk of getting PC. We will also be able to see if any of them act together to make the risk of PC much higher in certain men. This work should identify what lifestyle factors could reduce the risk of PC. It should also identify what genetic variations are associated with increased risk of PC and thus identify a sub group of men who might benefit from early medical attention or from changes in lifestyle.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