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HBPRCA
Email Newsletter
July
2007
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This issue is dedicated to Dr John Blair-West who regrettably passed away last month
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Welcome to the July e-news, which has turned out to be a
bumper issue. I am particularly pleased with this month’s feature article,
which was suggested (and introduced) by John Chalmers on the partnerships of
Australian cardiovascular researchers with our neighbours. If you missed
out on contributing your studies this time, Please contact me and we will
make room in a future issue. On that note we hope to put together a similar
feature focussing on indigenous cardiovascular health studies involving
council members and others. This is an advance invitation for contributions. I hope everyone has prepared their abstracts for the
Adelaide annual scientific meeting. In conjunctions with ASCEPT it is
certainly an event not to be missed. We are delighted to announce that the abstracts from the
Brisbane ASM that have now appeared in the June edition of Hypertension (Vol
49, Issue 6, pages 1462-14810). Also, please read below about our journal donations
project. We would like to call for your expression of interest. With best wishes, Associate Professor
Geoffrey A Head |
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PRESIDENT’S MESSAGE from Stephen Harrap The abstract submission deadline
for the Annual Scientific Meeting in Adelaide has now been announced and we
hope that you are not only compiling your own latest results, but also
encouraging those in your departments and institutes to do the same thing.
The program is looking marvellous and we can add to the list of high profile
attendees the President of the ISH Prof Lars Lindholm who is intending to be
with us in South Australia in December. I should also comment on the
absolutely marvellous job that Louise Burrell has been doing as our Corporate
Liaison on the Executive. She has been extraordinarily effective in
attracting new corporate sponsors as you might have noticed in the list of
sponsors and members in meeting details on the web. This not only helps
secure the finances of the Council, but it makes it possible to support our
initiatives directed towards our younger members and we hope to be able to
provide some extra support for the forthcoming meeting in Adelaide. So we’d
encourage students in particular to submit abstracts for our 2007 meeting so
that we can have a good number to chose from for travel support. |
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MEETING NEWS from Jaye Chin Dusting Eeek - it's July already!
If, like me, you have been flat out, spinning like a tornado (can one be flat
and spinning at the same time?) dealing with all the little challenges life
throws up, it is time to stop and prioritise. Call for abstracts for
the 29th HBPRCA Annual Scientific Meeting to be held in Adelaide are open and
it is time to focus on how to put your best foot forward. As always,
the meeting promises to be a great showcase for the best of cardiovascular
research internationally and in the country with fierce competition for great
prizes. Lined up as invited speakers we have Guido Grassi as
our RD Wright Lecturer (for short Bio see below), Ian Fraser
as our Austin Doyle Lecturer and Tien Wong, our Colin
Johnston Lecturer. As well we are optimistic that the current ISH
president, Lars Lindholm will be joining us. Remember: this years meeting is
a joint meeting with ASCEPT and we have 2 shared sessions on the Wednesday -
so book those flights in time for a Wednesday 3 pm start.
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MEMBERSHIP
NEWS from Doug
McKitrick Membership in the High Blood Pressure
Research Council of Australia continues to grow, particularly in the case of
student membership. If you have students that have not yet joined encourage
them to do so – membership is free, prizes for presented work are numerous
and overall HBPRCA membership is a tremendous opportunity for your students
to experience what it means to be part of a leading national society with
world-renowned national and international members. In recent times the HBPRCA
has stepped out on the national and international stage promoting
hypertension research through, for example, partnerships with overseas
hypertension societies, involvement in World Hypertension Day and
participation in the distribution of automated blood pressure measurement
machines that now sit in GP offices across the country bearing the HBPRCA
logo. Several new educational initiatives are under development and the input
and participation of all HBPRCA members is encouraged. So now is a great time
to be part of a vibrant, changing and growing scientific society. If you are sitting in your GP’s
office and notice the HBPRCA logo while your blood pressure is checked, use
it as a reminder to renew your own membership if you haven’t already done so.
Renewal may still be done by mail, fax or internet. If you have internet
access go to the Meetings First website
and follow the link for access to the secure payment site, or to download a
form for return by fax or post. If you don’t have internet access, can’t
remember if you have paid, or just need a bit of help, contact the
Secretariat by email, phone, fax or post (details below). And if you have
colleagues with interest in the diagnosis, treatment or research into the
causes of high blood pressure, encourage them to take advantage of HBPRCA
membership. |
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JOURNAL DONATIONS PROJECT – Call for Expressions of InterestI am currently working with the
Council ‘s Executive Committee to see whether Council members, as a group of researchers
and clinicians, can set up a project to donate our discarded journals to
needy recipients. We have in mind
medical schools and health professional training colleges in our near
geographical region to start with. The first step in determining whether
this project will be feasible is to gauge member’s interest in being
involved. Members wishing to participate will need to be prepared to release
journals for donation within six months of the publication date and to be
involved on a long-term basis. If you are interested in
becoming a donor, please email the HBPRCA Secretariat (hbprca@meetingsfirst.com.au),
by Friday 3 August 2007 along with
a list of journals you are willing to part with. I look forward to your positive
responses and hope that we’ll all able to work together on this worthwhile
project. We’ll keep you posted through the bulletin as we develop it. Graham MacDonald On behalf of the HBPRCA
Executive Committee |
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FOUNDATION
FOR HIGH BLOOD PRESSURE RESEARCH Postdoctoral Research Fellowship (2008) The
Foundation for High Blood Pressure Research was established following the
15th Scientific Meeting of the International Society of Hypertension in
Melbourne in 1994 to support research into hypertension and associated
cardiovascular diseases. The
Foundation is offering a two-year postdoctoral fellowship for a research
project in hypertension or related fields in basic, clinical or public health
areas at an Australian institution. Applications from biomedical, clinical
and public health researchers are invited. Applications
are open to Australian citizens or permanent residents. It is
expected that the successful applicant will have had not less than five and
not more than ten years' postdoctoral experience. The fellowship provides a
salary and modest project maintenance costs. Applications close on 3 September 2007 (Late
applications will not be considered) ISH Visiting Postdoctoral Award (2008) The
Foundation for High Blood Pressure Research was established following the
15th Scientific Meeting of the International Society of Hypertension in
Melbourne in 1994 to support research into hypertension and associated
cardiovascular diseases. The ISH
Visiting Postdoctoral Award has been designed to encourage experienced
researchers from countries other than Australia to work in Australia for up
to two years on a specific research project in hypertension or a related
field in basic, clinical or public health areas. The ISH
Visiting Postdoctoral Award will be awarded to an Australian research
institution, as a contribution towards the salary of a postdoctoral
researcher who is not an Australian citizen or permanent resident. Applications close on 3 September 2007 (Late
applications will not be considered) Application
Procedures For
information on how to apply please contact: FHBPR
Secretariat Department
of Physiology University
of Melbourne Parkville
3010 Victoria,
Australia Email: jkelly@unimelb.edu.au |
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6TH CONGRESS
OF THE Asian-Pacific
Society of Hypertension 16 - 19 November 2007 Beijing, China The Asian Pacific Society of
Hypertension invites all doctors involved in the treatment of people with
Hypertension and related cardiovascular, cerebrovascular and other disorders
to attend the 6th meeting of the APSH to be held in Beijing in November 2007.
In the forthcoming congress, a large portion of the
programme will be devoted to oral and poster presentations selected from the
abstracts submitted by the participants. The programme will also include
state-of-art lectures, debates and presentations of original research with
views of topics of basic and clinical interest from research centres of
hypertension from the region. Experts, investigators and clinicians from the
Asian Pacific region and other areas of the world will discuss issues on
hypertension and related cardiovascular diseases. Satellite Symposia
organized by Drug Industry, which will be held in the days before, after and
during the main meeting allow more specific information on new treatments of
hypertension and related cardiovascular diseases to be presented and
discussed. In separate sessions, research results of young investigators will
also be presented and awarded. In addition, presidents or Representatives of
Region Hypertension Societies will also meet to exchange new ideas on how to
improve our management on hypertension and related diseases in the region. The weather of Beijing in Mid-November is nice, the
temperature is moderate, neither cold nor hot. It is indeed the right time to
have such a scientific meeting in Beijing. For more information, please visit the website, www.apsh2007.com. The email contact is info@apsh2007.com. We look forward to seeing you in
Beijing in November 2007. Trefor Morgan Secretary General Asian Pacific Society of
Hypertension |
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NATIONAL BLOOD PRESSURE SCREENING DAY Up to 14,000 people were
screened for high blood pressure on Saturday 30th June, 2007 in
the first national population survey of its kind ever undertaken in
Australia. The National Blood Pressure Screening Day was designed by
Preventative Cardiology at the Baker Heart Research Institute and supported
by Schering-Plough Pty Limited. The
aim of the day was to gain a “snapshot” of the levels of blood pressure in the
adult Australian population to potentially highlight the need for better
management and control at the individual, GP and population level. It will also provide the latest data on
how many people are affected by high blood pressure in Australia. Free screening tests were
conducted by over 300 registered nurses at 100 selected shopping centres in
high population areas across every state and territory in Australia. The Baker Institute identified 100
locations (for shopping centres to be identified within) using geographical
information system profiling (see Figure 1).
Both rural and metropolitan sites were included in order for the data
to be representative of the general Australian population. Participants underwent a 10-minute
screening process that involved: Y
Completing a brief questionnaire about blood
pressure management and control, perceptions about risk and general
background information. Y
Having height, weight, waist and hip measurements
taken. Y
Undergoing two non-invasive automatic blood pressure
tests. Y
Receiving advice and “heart health tips” from
trained nurses and educational pamphlets explaining how to minimise high
blood pressure as a risk factor for heart disease. Most importantly, individuals
were provided with a report card to record their blood pressure measurement
together with advice to consult their GP (for high risk individuals) or to
continue having regular 6-monthly blood pressure check-ups (for people with
normal blood pressure levels). Knowing
that a blood pressure problem exists is the first step towards treatment,
whether that be via diet and exercise or controlled with anti-hypertensive
medication. Further, by enhancing
public knowledge about cardiovascular disease, through effectively
communicating information about risk factors such as high blood pressure, we
will hopefully assist in reducing an escalation of cardiovascular disease in
Australia.
Preliminary results from the
National Blood Pressure Screening Day suggest that as many as 40% of
Australians have high blood pressure.
These figures are alarming and point to a looming epidemic of heart disease
and stroke. More detailed results
will provide invaluable data on the heart attack and stroke risk of the
average Australian. At the local
level, the screening site and postcode of participants will be used to derive
regional-specific data for comparison to national averages and highlight
potential issues of concern in relation to optimal screening for and
management of high blood pressure. For more information about the
National Blood Pressure Screening Day, contact Preventative Cardiology at: Freecall: 1800 998 722 Email: preventativecardiology@baker.edu.au
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ASMR Professional Development Program I am pleased to announce the
2007 ASMR Professional Development Program to be held in three major cities:
Brisbane Wednesday 29 August Sydney
Thursday 30
August
ASMR President |
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JULY FEATURE ARTICLE
– Australian Collaborative
International Research In the era of globalisation,
much research involves worldwide collaboration. This is certainly so with blood
pressure research. In the fields of epidemiology and clinical trials,
Australian researchers have been active in many collaborative projects with
overseas colleagues. There has quite naturally been a strong focus on the
Asia-Pacific region, our own part of the world, but also very far-flung
collaboration across all continents. We bring together here a sample of
projects reaching out to the massive populations in the developing world,
showing some work in progress in India, China and South Africa. Professor John Chalmers Cardiovascular
mortality and morbidity in rural Andhra Pradesh, India R Joshi, C Chow, B
Neal from The George Institute for International Health, University of
Sydney, Sydney, Australia India is undergoing rapid
epidemiological transition as a consequence of economic and social change,
and cardiovascular disease is becoming an increasingly important cause of
death. While some information is available for urban areas, data about
cardiovascular disease in rural areas, where 70% of the Indian population
resides, is scant. The George Institute for
International Health, together with the Byrraju Foundation, Hyderabad, CARE
Foundation, Hyderabad and Centre for Chronic Disease Control, New Delhi
established a research collaboration (The Andhra Pradesh Rural Health
Initiative). The overall goal of this
initiative was to develop and evaluate locally applicable new strategies for
the improvement of health in poor rural
communities. In order that the interventions selected address the leading
burdens of disease and their cause the collaboration has collected data about
morbidity and mortality through a large-scale survey and a mortality
surveillance system.
The
survey used simple standardized instruments to measure the prevalence of
non-fatal cardiovascular disease and cardiovascular risk factors amongst a
random sample of 4535 adults aged 30 years and over (response rate 81%) in 20
villages broadly representative of the East and West Godavari region of
Andhra Pradesh. The mortality surveillance
system was established in 45 villages and all deaths occurring in the
villages (population 180,162) were recorded during a 12-month period in
2003-4. Primary healthcare workers trained in the use of a standard verbal
autopsy tool collected data about the deaths. Algorithms were used to define
causes of death according to a limited list derived from the international
classification of disease version 10.
Causes were assigned by two independent physicians with disagreements
resolved by a third. The
survey found high levels of diabetes (13.2%), hypertension (27.0%),
overweight/obesity (men 18.4%, women 26.3%) and smoking (men 45.2% and women
4.8%). A third of the adult population had total cholesterol above 5.2 mmol/l
and 15.2% had a positive family history of cardiovascular disease. A diagnosis of coronary heart disease
(myocardial infarction and angina) was reported by 4.8% and stroke by 2.0%.
1354
deaths were identified (crude death
rate 7.5/1000) with verbal autopsies completed for 98% of all deaths.
Cardiovascular diseases were the leading causes of mortality, responsible for
33% of all deaths. The rates of ischemic heart disease and cerebrovascular disease were similar and these two
constituted the majority of the vascular deaths recorded (ischaemic heart
disease 14%, cerebrovascular disease 13%, and other vascular causes 6%). Cardiovascular diseases were responsible
for a greater proportion of deaths among men than women and about one quarter
of all cardiovascular deaths occurred below the age of 60 years. Conclusions Cardiovascular
disease is a surprisingly large health
problem in this developing rural region. In addition to the many deaths caused by
vascular disease there are also a significant number of very high-risk
individuals with prevalent cardiovascular disease and many with substantially
abnormal levels of other major risk factors.
It appears that in large part the burden of cardiovascular disease in
this community is attributable to broadly the same chief causes as in other
parts of the world. Addressing the
problem will however present a significant challenge to a health system whose
resources are currently focused on communicable diseases and reproductive
health. Novel low-cost strategies
that are suited to this very resource poor setting need to be developed and
evaluated if the epidemic of vascular disease affecting India is to be
attenuated. The collaboration is
currently midway through a first cluster-randomised trial evaluating a
strategy seeking to identify and treat some of the highest risk individuals. Table 1:
Cardiovascular morbidity and mortality in rural Andhra Pradesh
The Rishi Valley Vascular Disease Survey Mandy Thrift from the Baker Heart Research Institute
This survey is being conducted in the Rishi Valley, an area situated in
the interior of rural Andhra Pradesh, a major South Indian State. It is a
sheltered, drought-prone valley about 140 km northeast of the city of
Bangalore, and is home to the villages of a stable rural community of
approximately 35,000 residents. The population consists primarily of
shepherds and marginal subsistence farmers, with landholdings of less than
one acre. The average monthly income for a family of five (husband, wife, two
children, and one dependent elder) ranges from between Rs. 700 to Rs. 1,000
per month (which is equivalent to 65 to 93 cents per day). This is well below
the global standard for poverty. Residents
of the villages are being interviewed to obtain information about their lifestyle
(diet, activity, smoking, alcohol). Blood pressure, height, weight, waist and
hip are being measured using standard criteria. In addition, finger-prick
tests for blood glucose, cholesterol, triglyceride and haemoglobin are also
being performed. This
survey will provide important and comprehensive data regarding the prevalence
of vascular disease risk factors in a rural Indian community. It will be the
first major step in planning effective public health interventions to treat
or prevent vascular disease in a disadvantaged Indian community. This is a collaborative project
between Mandy Thrift, Sharyn Fitzgerald (Baker Heart Research Institute),
Velandai Srikanth, Roger Evans (Monash University), Kartik Kalyanram and
Kamakshi Kartik (Rishi Valley Rural Health Centre). The
Heart of Soweto Study By
Geraldine Lee and Melinda Carrington (Baker Heart Research Institute)
Soweto in South Africa compromises of a series
of townships and is located southwest of Johannesburg. It contains the
largest urban concentration of Black Africans with an estimated population of
1 to 1.5 million, which includes a steady influx of migrants. The townships
are undergoing economic transition leading to increased affluence. This in
turn has resulted in the development of chronic forms of cardiovascular
disease (CVD) and this has necessitated the need for
systematic surveillance programs to monitor & implement
prevention/management programs for the emerging CVD. The primary goal of the “Heart of Soweto Study” is to
systematically examine and respond to the epidemiologic transition in risk
behaviours and clinical presentations of heart disease in the internationally
renowned and celebrated community of Soweto. Within the Baragwanath Hospital (with a
3,500 bed capacity), the Coronary Care Unit has observed more than a 10-fold
increase with patients suffering heart attacks over the past 20 years and
approximately 100 patients a day attend the out-patient clinic for
heart-related complaints. Approximately 5000 patients per annum are diagnosed
with heart disease. A clinical registry of all patients managed by the Cardiology Unit
has been established. The Cardiologists/Trainee Cardiologists carries out
medical reviews according to standard protocols and diagnoses and the data
are validated and entered on-site via a dedicated research team with support,
verification and analyses via University of Queensland & the Baker Heart
Research Institute in Australia. The
clinical registry has revealed that at least 20% of new cases of heart
disease presenting to the Cardiology Unit at the Baragwanath Hospital have
developed CHF; this equates to approximately 250 new cases of heart failure
presenting to the clinic each year. The aetiology of heart failure includes
dilated cardiomyopathy, valvular heart failure right heart failure and
ischaemic cardiomyopathy. Several sub studies have also been initiated in areas including HIV,
nutrition, screening for CVD risk factors, ECG abnormalities and
socio-economic status. In summary, demonstrated the broad & substantive spectrum
of heart disease in Soweto, South Africa, the high prevalence
of risk factors such as hypertension, smoking and a
positive family history and late clinical presentations. The study has
demonstrated the need for
sustained surveillance & new health care programs. References: Stewart S, et al.. Mapping the emergence
of heart disease in a black, urban population in Africa: The Heart of Soweto
Study. Int J Cardiol 2006;108: 101-108 The ChinaQUEST (QUality Evaluation of Stroke care and
Treatment) study Professor Craig Anderson,
The George Institute for International Health Background: China, as the most populous country on
earth, has a heavy burden of stroke and other vascular diseases. According to WHO estimates, nearly 30% of
the 5.5 million deaths from stroke that occurred in the world in 2002 were in
China, reflecting the very large (1.4 billion) population who are at high
risk of vascular disease. Studies
have shown marked geographical variation in rates, prevalence and case
fatality of stroke in China, with a well-described North-South gradient
favouring southerners and a widening urban-rural gap in the burden of
disease. The extent to which current
patterns of stroke in China are driven by differences in the prevalence of
risk factors and case fatality is unclear.
The decreasing stroke mortality rate seen in the WHO-MONICA study in
China during 1982-1995 was almost all due to improvements in survival rather
than a fall in stroke incidence per se.
This may be due to improved medical care for stroke patients, although
changes in stroke risk factors over time may have lead to the occurrence of
milder forms of stroke with improved outcomes. Currently, the country is
experiencing significant management issues in stroke arising from the
increasing numbers of patients from the rapidly ageing population who are
undergoing social and economic change.
There has traditionally been a heavy reliance of acute hospital care
for chronic diseases and very little preventative and community care. Only recently has a health insurance
scheme been introduced to help support the cost of health care in a largely
fee-for-service health care setting.
In the absence of reliable epidemiological data, it is difficult to
quantify the degree of disparities in care and plan services, both preventative
and therapeutic, in an equitable and evidence-based manner. Methods: The ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) project is a large-scale, China-Australia partnership, epidemiological project that aims to (a) describe current patterns of stroke management in China | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
