Publications by authors named "S B Harrap"
Background And Aims: Accumulating evidence indicates that reducing high blood pressure (BP) prevents dementia and mild cognitive impairment (MCI). Furthermore, although diabetes is a risk factor for dementia and MCI, there is uncertainty of the effect of intensive glucose control on these endpoints. This study aimed to determine the effects of BP-lowering (vs placebo) and intensive glucose-lowering (vs standard control) treatments according to baseline cognition and other characteristics on dementia and cognitive decline (CD) in people with type 2 diabetes mellitus (T2DM).
View Article and Find Full Text PDFObjective: To compare the vascular effects of pursuing more versus less glucose lowering in patients with younger or older age at diabetes diagnosis, and with shorter or longer diabetes duration.
Research Design And Methods: We studied 11,138 participants from the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial, classified into subgroups defined by age at diabetes diagnosis (≤50, >50-60, and >60 years) and diabetes duration (≤5, >5-10, and >10 years).
Results: Intensive glucose lowering significantly lowered the risk of the primary composite outcome of major macrovascular and microvascular events (hazard ratio 0.
Article Synopsis
- The study aimed to determine if apolipoproteins and VLDL cholesterol are better predictors of macro- and microvascular disease risk than traditional lipid markers in individuals with diabetes, while also exploring potential sex differences.
- The research analyzed data from over 11,000 participants with type 2 diabetes, focusing on apolipoproteins and established lipid risk markers to assess their associations with health outcomes like disease events and death.
- Results indicated that higher HDL cholesterol was linked to a reduced risk of macrovascular complications, while higher levels of total cholesterol, LDL cholesterol, non-HDL cholesterol, and the total cholesterol/HDL ratio correlated with increased risk; triglycerides did not show significant associations.
Article Synopsis
- The ADVANCE trial examined the impact of intensive blood pressure lowering with perindopril-indapamide in patients with type 2 diabetes, revealing significant advantages in reducing cardiovascular and mortality risks.
- Secondary analyses identified important risk markers in diabetes, such as the effects of stopping BP therapy and specific cardiac biomarkers.
- The study also highlighted practical challenges in hypertension management, including limitations of traditional office BP readings and insights on the tolerability of combination therapy.
Four-week inhibition of the renin-angiotensin system in spontaneously hypertensive rats results in persistently lower blood pressure with reduced kidney renin and changes in expression of relevant gene networks.
Cardiovasc Res
May 2024
Aims: Prevention of human hypertension is an important challenge and has been achieved in experimental models. Brief treatment with renin-angiotensin system (RAS) inhibitors permanently reduces the genetic hypertension of the spontaneously hypertensive rat (SHR). The kidney is involved in this fascinating phenomenon, but relevant changes in gene expression are unknown.
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